Unique Features of a Comprehensive Genomic Profiling Panel: Expanding Treatment Options in a Value-Based Community...

Comprehensive genomic profiling (CGP) is strongly advocated by organizations like ASCO and National Comprehensive Cancer Network (NCCN) to tailor precision-guided therapies for patients with cancer. However, these guidelines often lack specificity regarding panel size or essential features required within CGP panels.

A pilot pan-cancer study of patients (N = 85) treated in a value-based community health care setting who received next-generation sequencing (NGS)-based CGP from Tempus AI, Inc and an expanded analysis of de-identified patient records from the Tempus database (N = 465) for patients treated within a community health care network. Rates of potentially actionable findings defined as variants matching US Food and Drug Administration -approved therapies (somatic variants/resistance markers, Tumor Mutational Burden high [TMB-H] or Microsatellite Instability high [MSI-H]), or identification of pathogenic/likely pathogenic germline findings. Enrollment in clinical trials was included in the expanded cohort.

In our pilot cohort, potentially actionable alterations were detected in 49% of patients (n = 42). Of them, 12% (n = 5) of patients had a finding that was identified only by advanced features-including tumor-normal match, RNA sequencing, and/or liquid biopsy reflex testing-and may have been missed by the existing in-network NGS options. In the expanded cohort, potentially actionable alterations were detected in 31% (n = 146) of patients. Of them, 12% (n = 17) had findings identified solely by advanced features, including three patients enrolled in clinical trials.

This study indicates that the CGP expanded treatment options in both the pilot and expanded cohort, with improvements directly attributable to specific features like tumor-normal matching, liquid biopsy reflex ordering, RNA sequencing, and Just-in-Time clinical trial matching.