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Gregory J. Riely, MD, PhD

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Can Comprehensive Genomic Profiling Influence Clinical Outcomes in Advanced NSCLC?

By: Vanessa A. Carter, BS
Posted: Thursday, August 1, 2024

George R. Simon, MD, of Moffitt Cancer Center, Tampa, Florida, and colleagues compared targeted therapy receipt, real-world overall survival, and actionable biomarker detection in patients with advanced non–small lung cancer (NSCLC) who underwent small-panel testing or comprehensive genomic profiling. Published in JCO Precision Oncology, the results of this study suggest that patients who received comprehensive genomic profiling experienced improved use of targeted therapy and biomarker detection—both correlating with prolonged survival.

“[Comprehensive genomic profile] testing can unlock personalized treatment options and improve downstream clinical outcomes,” concluded the study authors. “Therefore, broadening the access and uptake of comprehensive genomic profile testing enabling patients to receive molecularly driven precision therapies is paramount to improving outcomes in patients with advanced NSCLC.”

A total of 3,884 adults with advanced NSCLC who underwent biomarker testing were enrolled in the study. Participants were categorized according to their testing method (comprehensive genomic profiling vs small-panel testing) and were followed until death or study completion. Small-panel testing evaluated no more than 52 genes, and comprehensive genomic profiling assessed more than 52 genes.

Although the majority of patients underwent small-panel testing (80%), significantly more individuals who received comprehensive genomic profiling had at least one actionable biomarker (P < .001). Of note, more patients who had comprehensive genomic profiling received matched therapies compared with those who had small-panel testing (42% vs 38%). Furthermore, participants who received comprehensive genomic profiling before their initial therapy had a higher likelihood of matched therapy at any point (odds ratio = 3.2).

Both having at least one actionable biomarker and undergoing comprehensive genomic profile testing correlated with a reduced mortality risk, according to the investigators. Individuals who had at least one actionable biomarker demonstrated improved median real-world overall survival with matched therapy compared with unmatched therapy in both the comprehensive genomic profiling (34 vs 14 months) and small-panel testing (27 vs 10 months) cohorts.

Disclosure: For full disclosures of the study authors, visit ascopubs.org.