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Published on: April 11, 2016
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.
Introduction:
Comprehensive genomic profiling (CGP) enables identification of patients eligible for targeted treatments, making it essential in the management of advanced cancer. This retrospective real-world study compared actionable mutations in CGP-tested patients with advanced/metastatic solid tumors to those who received single-gene/small-panel (SP) tests.
Methods:
Patients aged > 18 years with advanced/metastatic solid tumors (including non-small cell lung cancer (NSCLC), colorectal cancer, prostate cancer, breast cancer, or melanoma) with a CGP or SP test reported between 1 January 2018, and 31 December 2022, were included. OncoKB-derived actionability was compared between the two cohorts. Inverse probability of treatment weighting (IPTW) was used to adjust for baseline characteristics. A weighted generalized linear model with log link was used to report actionability ratio (AR) and 95% confidence intervals (CI).
Results:
Among 406 patients (CGP-tested cohort: 202, SP-tested cohort: 204), approximately half were diagnosed with NSCLC. After adjusting for baseline characteristics, CGP testing detected more actionable alterations than SP: OncoKB level 1 (50.0% versus 31.4%; AR 1.76 [95% CI: 1.24, 2.51]; p = 0.002), OncoKB level 2 (22.8% versus 10.3%; AR 2.53 [95% CI: 1.17, 5.48]; p = 0.018), and OncoKB level 1 or level 2 or level R1 (55.9% versus 41.2%; AR 1.5 [95% CI: 1.11, 2.01]; p = 0.008).
Conclusions:
CGP testing identified more actionable genetic alterations compared with SP testing methods for patients with advanced/metastatic NSCLC, colorectal cancer, prostate cancer, breast cancer, or melanoma. Expanding reimbursement and coverage for CGP testing as well as expanding CGP use can facilitate equitable treatment access for patients with advanced/metastatic cancer.
Insights
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.
