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Clinical Implementation Gap of Comprehensive Genomic Profiling in Pancreatic Cancer: A Real-world Study.
Masataka Ando1, Tadahisa Inoue2, Takashi Iwata3
1Department of Gastroenterological Surgery, Aichi Medical University, Nagakute, Japan; mando@kj8.so-net.ne.jp.
In Vivo (Athens, Greece)
|June 30, 2026
Summary
Comprehensive genomic profiling (CGP) in pancreatic cancer identified actionable alterations in 8.8% of patients, but only 3.5% received matched therapy due to implementation barriers, not clinical decline.
Area of Science:
- Oncology
- Genomics
- Precision Medicine
Background:
- Comprehensive genomic profiling (CGP) is growing in use for pancreatic ductal adenocarcinoma (PDAC).
- The real-world clinical utility of CGP in PDAC is not well-established.
- Understanding attrition from genomic detection to treatment is crucial.
Purpose of the Study:
- To evaluate the stepwise process from genomic detection to treatment implementation in routine PDAC care.
- To identify barriers limiting the clinical impact of CGP in PDAC.
Main Methods:
- Retrospective single-institution study of PDAC patients undergoing CGP.
- Assessment of attrition rates at genomic detection, expert panel review, and treatment execution.
- Analysis of clinical characteristics and overall survival (OS).
Main Results:
- Only 8.8% of 57 PDAC patients had actionable genomic alterations; 3.5% received genotype-matched therapy.
- Attrition was mainly due to regulatory/diagnostic constraints, not patient clinical decline (91.2% ECOG 0-1).
- No significant difference in OS was found between patients with or without CGP-attributed impact.
Conclusions:
- Actionable alterations are found in a small subset of PDAC patients, with even fewer receiving matched therapy.
- Implementation barriers, not genomic detection, limit CGP's clinical impact in PDAC.
- Earlier CGP integration and better access to matched therapies could improve outcomes.
