Comprehensive Genomic Profiling Across Diverse Solid Tumors: A Real-World Experience From India With...

Area of Science:

• Oncology
• Genomics
• Molecular Diagnostics

Background:

• Precision oncology increasingly utilizes comprehensive genomic profiling (CGP) via next-generation sequencing (NGS) assays like FoundationOne®CDx (F1CDx) to guide targeted therapies.
• Understanding the mutational landscape and actionable alterations in diverse solid tumors is crucial for optimizing treatment strategies.

Purpose of the Study:

• To evaluate the mutational landscape, identify actionable genomic alterations, and assess the clinical utility of F1CDx testing in a diverse cohort of solid tumors at an Indian oncology center.
• To analyze the frequency and types of genomic alterations across common and rare cancer types in the Indian population.

Main Methods:

• A retrospective analysis of de-identified demographic, clinical, and genomic data from 115 adult patients who underwent F1CDx testing between August 2017 and April 2025.
• Somatic alterations were prioritized, and gene-level alteration frequencies were calculated. Descriptive statistics summarized clinical and molecular findings. Genomic actionability was assessed based on report-level or biological relevance.

Main Results:

• The most common cancers included breast (n=35), gastrointestinal (n=22), lung (n=18), and gynecologic (n=15).
• Distinct tissue-specific genomic signatures were observed, involving MAPK, PI3K/AKT/mTOR, RTK, DNA repair, and cell cycle pathways.
• F1CDx identified actionable alterations recommending FDA-approved therapies in 41.7% of cases and tumor-agnostic or off-label therapies in 50.4%.

Conclusions:

• F1CDx comprehensive genomic profiling revealed a wide array of actionable alterations across various solid tumors in the Indian context.
• The study highlights the potential of F1CDx to broaden therapeutic options and enhance the practice of precision oncology in real-world Indian clinical settings.
• Genomic signatures varied by tumor type, underscoring the need for tailored diagnostic approaches.