Clinical actionability and therapy selection for advanced NSCLC patients tested using comprehensive genomic profiling

Background: Comprehensive genomic profiling (CGP) enables physicians to recommend advanced cancer treatments at the individual level by identifying patients that are likely and unlikely benefit from targeted therapy or immunotherapy (IO). We assessed utility of CGP-based testing for biomarkers associated with approved therapies, therapies in precision medicine basket clinical trials (CT) across a large cohort NSCLC Providence health system. Methods: Advanced were tested utilizing CGP workflow between 2019 2021. Clinical actionability was based on OncoKB Tier 1 AMP/ASCO/CAP categorization: FDA recognized (Level 1), standard care 2), predictive resistance an drug R1). CT matching enrollment criteria ASCO-TAPUR, NCI-MATCH My Pathway CTs time testing. Systemic post CGP-testing among whose managed Pooled electronic medical record data curated standardized. Results: 466 followed up management Providence, 49% female, 83% white, median age 69 years. 59% (277) had least actionable biomarker and/or guideline recommended (based levels 1,2, R1), 61% eligible 3 trials. Of patients, 9% did not receive any directed received only supportive care. Patients treated using following systemic line testing: chemotherapy (97[21%]), + IO (140 [30%]), (83 [18%]), community setting (91 [20%]), (7 [2%]), off label use (2 [0.4%]). 91 who therapy, 84 (92%) oncogene while 7 (8%) NSCLC-specific indications. Conclusions: results high proportion both on-label genomically-informed Moreover, comprehensive detection simultaneously leads optimal treatment selection. Conflict interest: Ownership: Bela Bapat Brock Schroeder employees Illumina, Inc. Corporate-sponsored Research: Brian Piening is recipient research grant Illumina