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Real-World Actionability Analysis of Comprehensive Genomic Profiling Versus Single/Small-Gene Panels
Paul Spin1, Bela Bapat2, Chad Moretz3,4
1EVERSANA™, 1212-1175 Douglas Street, Victoria, BC, V8W2E1, Canada. paul.spin@eversana.com.
Oncology and Therapy
|June 21, 2026
Summary
Comprehensive genomic profiling (CGP) identifies more actionable mutations in advanced cancers than single-gene/small-panel (SP) tests. Expanding CGP use can improve treatment access for patients with solid tumors.
Area of Science:
- Oncology
- Genomics
- Molecular Diagnostics
Background:
- Comprehensive genomic profiling (CGP) is crucial for identifying targeted treatment eligibility in advanced cancer management.
- Real-world data comparing CGP with single-gene/small-panel (SP) testing for actionable mutations in advanced solid tumors is limited.
Purpose of the Study:
- To compare the detection of actionable genetic alterations between CGP and SP testing in patients with advanced/metastatic solid tumors.
- To evaluate the impact of different genomic testing strategies on identifying potential targeted therapies.
Main Methods:
- Retrospective study of 406 patients with advanced/metastatic solid tumors (NSCLC, colorectal, prostate, breast, melanoma) tested with CGP or SP between 2018-2022.
- OncoKB-derived actionability was compared between cohorts, with adjustments for baseline characteristics using Inverse Probability of Treatment Weighting (IPTW).
- Weighted generalized linear models were used to calculate the actionability ratio (AR) and 95% confidence intervals (CI).
Main Results:
- CGP testing identified significantly more actionable alterations than SP testing.
- Actionable alterations (OncoKB level 1) were found in 50.0% of CGP patients vs. 31.4% of SP patients (AR 1.76; p=0.002).
- Higher detection rates for OncoKB level 2 and combined levels 1/2/R1 were also observed with CGP.
Conclusions:
- Comprehensive genomic profiling (CGP) is superior to single-gene/small-panel (SP) testing in identifying actionable genetic alterations in advanced cancers.
- Increased use and reimbursement for CGP testing can enhance equitable access to targeted treatments for patients with advanced/metastatic solid tumors.
