Clinical impact for advanced non-small-cell lung cancer patients tested using comprehensive genomic profiling at a large USA health care system

Background

New breakthroughs in precision therapies are transforming cancer care for patients with advanced non-small-cell lung cancer (NSCLC). To this effect, comprehensive genomic profiling (CGP) has emerged as a streamlined workflow to test for all relevant tumor biomarkers within a single assay. Despite this, there are still significant gaps in access to CGP testing, with many patients only tested for a subset of biomarkers or not tested at all.

Materials and methods

We assessed the clinical impact of wide deployment of an in-house CGP assay at a large health care system in the United States by analyzing a cohort of advanced-stage NSCLC patients who received CGP testing and a retrospective cohort that was tested with a prior-generation 50-gene assay (small panel).

Results

Seventy-seven percent of CGP-tested NSCLC patients had one or more tumor biomarkers that were actionable for a precision therapy compared to 63% of small panel-tested patients. CGP-tested patients with an actionable biomarker received appropriate precision therapies at a higher rate than small panel-tested patients (64% versus 50%, P < 0.001), and there were marked improvements in survival outcomes for patients tested with CGP [median overall survival (OS) 15.7 months versus 7 months, P < 0.0001].

Conclusions

These data demonstrate clear precision therapy selection and patient OS benefits from universal access to CGP testing. Despite this, not all patients with an actionable biomarker received a precision therapy, suggesting that there are still gaps between access to CGP testing and access to precision therapies.