Oncologist uptake of comprehensive genomic profile guided targeted therapy

Mary K. Nesline, Paul DePietro, Grace K. Dy, Amy Early, Antonios Papanicolau-Sengos, Jeffrey M. Conroy, Felicia L. Lenzo, Sean T. Glenn, Hongbin Chen, Anne Grand'Maison, Patrick Boland, Marc S. Ernstoff, Igor Puzanov, Stephen Edge, Stacey Akers, Mateusz Opyrchal, Gurkamal Chatta, Kunle Odunsi, Peter Frederick, Shashikant LeleMark Gardner, Carl Morrison

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


We describe the extent to which comprehensive genomic profiling (CGP) results were used by oncologists to guide targeted therapy selection in a cohort of solid tumor patients tested as part of standard care at Roswell Park Comprehensive Cancer Center June 2016-June 2017, with adequate follow up through September 2018 (n = 620). Overall, 28.4% of CGP tests advised physicians about targeted therapy use supported by companion diagnostic or practice guideline evidence. Post-test targeted therapy uptake was highest for patients in active treatment at the time of order (86% versus 76% of treatment naïve patients), but also took longer to initiate (median 50 days versus 7 days for treatment naïve patients), with few patients (2.6%) receiving targeted agents prior to testing. 100% of patients with resistance variants did not receive targeted agents. Treatment naïve patients received immunotherapy as the most common alternative. When targeted therapy given off-label or in a trial was the best CGP option, (7%) of patients received it. Our data illustrate the appropriate and heterogeneous use of CGP by oncologists as a longitudinal treatment decision tool based on patient history and treatment needs, and that some patients may benefit from testing prior to initiation of other standard treatments.

Original languageEnglish
Pages (from-to)4616-4629
Number of pages14
Issue number45
StatePublished - 2019


  • Clinical decision making
  • Comprehensive genomic profiling
  • Next-generation sequencing
  • Real world data
  • Targeted therapy


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