More Insights. Fewer Missed Opportunities.
With a single test, comprehensive genomic profiling (CGP) can analyze a broad panel of genes to detect the four main classes of genomic alterations known to drive cancer growth: base substitutions, insertions and deletions, copy number alterations (CNAs), and rearrangements or fusions. This type of molecular testing produces comprehensive patient reports with a broad and deep assessment of possible underlying oncogenic drivers.
More and more patients can benefit from molecular profiling due to the rapidly growing number of targeted therapies. These include novel therapies being developed for less prevalent gene alterations like NTRK fusions, which have been identified in less than 1% of all cancers.1 Today, analyzing a broader panel of genes for multiple classes of alterations has become increasingly important.
Understanding the Difference Can Make a Difference.
Detects the four main classes of genomic alterations across a broader panel of genes
Identifies alterations that are confined to a single gene, potentially missing clinically relevant mutations in additional genes
May test multiple genes at a time, but it is confined to hotspot regions within those genes, resulting in potentially missing other clinically relevant classes of alterations
Biomarkers shown in table above are examples of relevant and emerging biomarkers in non-small cell lung cancer (NSCLC). Size is not representative of frequency of alterations.
Common, Complex, and Rare
Comprehensive genomic profiling can provide more complete information on common oncogenic drivers (like EGFR, KRAS, BRAF in NSCLC for example) and new information on complex or rare biomarkers (like MET Exon 14, NTRK1, NTRK2, NTRK3 in NSCLC for example) all from a single test.3,4
Relevant Genomic Signatures
Comprehensive genomic profiling results may include microsatellite instability (MSI) and tumor mutational burden (TMB). Genomic loss of heterozygosity (gLOH) can also be determined through comprehensive genomic profiling.
In some cases, sequential testing of single biomarkers or use of limited molecular diagnostic panels may quickly exhaust sample. Professional guidelines5,6 recommends that broad molecular profiling be done as part of biomarker testing for eligible patients using a validated test, which can help minimize tissue use and potential wastage.
For tumor genomic testing in eligible patients, use of tissue is recommended by professional guidelines, with use of plasma ctDNA (liquid biopsy) assays as an option if obtaining sufficient tissue is not clinically feasible.5-7 A study in NSCLC found that 29% of patients didn’t get results from molecular testing because tissue was insufficient.8 In such cases, you need a portfolio that includes liquid-based comprehensive genomic profiling.
Comprehensive genomic profiling can help you keep up to date with the most recent treatment options available throughout the patient’s treatment journey.
NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
1Fabrizio, et al. Clinical and analytic validation of FoundationOne CDx for NTRK fusion-positive solid tumors in patients treated with entrectinib. In: Proceedings of the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics; 2019. AACR; Mol Cancer Ther 2019; Abstract A028. doi:10.1158/1535-7163.TARG-19-A028
2IQVIA Institute for Human Data Science. (August 2020). Supporting Precision Oncology: Targeted Therapies, Immuno-oncology, and Predictive Biomarker-Based Medicines. Retrieved from https://www.iqvia.com/insights/the-iqvia-institute/reports/supporting-precision-oncology
3Drilon A, et al. Broad, hybrid capture-based next-generation sequencing identifies actionable genomic alterations in “driver-negative”lung adenocarcinomas. Clin Cancer Res 2015;21:3631-3639.
4Rozenblum AB, et al. Clinical impact of hybrid capture-based next-generation sequencing on changes in treatment decisions in lung cancer. J ThoracOncol 2017;12(2):258-68.
5Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Esophageal and Esophagogastric Junction Cancers V.3.2021.© National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed July 29, 2021. To view the most recent and complete version of the guideline, go online to NCCN.org
6Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer V.5.2021.© National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed July 29, 2021. To view the most recent and complete version of the guideline, go online to NCCN.org.
7Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Prostate Cancer V.2.2021.© National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed July 29, 2021. To view the most recent and complete version of the guideline, go online to NCCN.org.
8Kris, M. G. et. al. (2014). Using Multiplexed Assays of Oncogenic Drivers in Lung Cancers to Select Targeted Drugs. JAMA. 2014;311(19):1998-2006.
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