Comprehensive Genomic Testing Expands Treatment Options for Advanced Cancers

As options dwindle, many patients face decisions without strong molecular guidance. Broader sequencing across cancer types can reveal clinically relevant variants that reshape treatment planning. A new study shows that comprehensive genomic profiling can open additional therapeutic paths for nearly one in three patients.

Researchers at London Health Sciences Centre Research Institute (LHSCRI; London, ON, Canada) evaluated comprehensive genomic profiling using next-generation sequencing (NGS) to analyze hundreds of cancer-related genes in solid tumors. Conducted at London Health Sciences Centre’s (LHSC) Verspeeten Family Cancer Centre, with interpretation by the Verspeeten Clinical Genome Centre, the program goes beyond standard panels that examine only a limited set of genes. The study assessed whether broader genomic testing could better match patients to targeted therapies and clinical trials.

NGS screens genes linked to numerous cancer types at the same time, enabling detection of clinically relevant alterations that standard testing may miss. Findings can support access to therapies not typically used for a given tumor type, including off‑label and compassionate‑use treatments, and can facilitate enrollment in clinical trials. In routine practice, this approach helps guide selection of options most likely to benefit individual patients.

The prospective study, published in The Journal of Molecular Diagnostics, included 554 patients with gastrointestinal, lung, head and neck, breast, gynecologic, genitourinary, brain and nervous system, sarcoma, skin, and cancers of unknown origin. All participants received advanced DNA testing at LHSC’s Verspeeten Family Cancer Centre with analysis by the Verspeeten Clinical Genome Centre. The work is part of the POWER (Precision Oncology at Western University) initiative and was conducted in real‑world settings.

Clinically relevant genetic variants were identified in 79% of patients. Overall, 28% became eligible for new treatment options—such as clinical trials, off‑label therapies, or compassionate access programs—that had previously been unavailable. Additional system‑level effects in Ontario included safer options identified for 14.5% of patients, earlier selection of effective treatments for 12.5% that reduced later use of more costly publicly funded drugs, and adjusted treatment sequencing for 17.3% to deliver therapies at the most appropriate time.

The results give physicians evidence to support access to off‑label and compassionate‑use treatments by linking therapies to tumor DNA. The research team is continuing this prospective study and collecting more information about the impact of expanded testing on patient outcomes and the broader health system. Areas of ongoing assessment include patient outcomes and health‑system effects.

“This study is one of the first to show, in real-world settings, that broader testing can find important changes in a tumor's DNA and help identify alternative treatment options. In almost one in three patients we tested, we found changes in their DNA that would make them eligible for different therapies that may be more effective than the standard of care,” said Dr. Bekim Sadikovic, scientist at LHSCRI and head of the Verspeeten Clinical Genome Centre.

“I meet with patients every day whose only remaining options are compassionate access to a specific drug or enrollment in a clinical trial. This kind of evidence helps us make more informed decisions, so patients are not asked to endure treatments that are unlikely to help and instead are guided toward options with real potential,” said Dr. Stephen Welch, scientist at LHSCRI and medical oncologist at LHSC.

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