Clinical Utility of Comprehensive Genomic Profiling in a Community Hospital Outside the Cancer Genomic Core Hospital Network: A Single-Center Retrospective Cohort Study

TL;DR

This study shows that genomic profiling in a community hospital can help some cancer patients get targeted treatments, even though it didn't improve overall survival.

Contribution

Demonstrates feasibility and clinical impact of CGP in a community hospital outside Japan's core cancer genomic network.

Findings

24% of patients underwent CGP, with 75% identifying druggable genomic alterations.

12% of CGP patients received genomically matched therapy, including clinical trials and targeted agents.

No significant difference in overall survival between CGP and non-CGP groups.

Abstract

Background

Comprehensive genomic profiling (CGP) has become increasingly integrated into precision oncology; however, its real-world clinical utility in community hospitals outside the national cancer genomic core hospital network in Japan remains less studied. This study aimed to evaluate the implementation, feasibility, and clinical impact of CGP in a community-based hospital.

Methods

We retrospectively reviewed patients with unresectable or recurrent solid tumors who had not received systemic chemotherapy at our hospital between April 2021 and December 2025. Clinical outcomes, including the detection rate of druggable genomic alterations, the proportion of patients who received genomically matched therapy, and overall survival (OS), were compared between patients who underwent CGP and those who did not.

Results

Among 253 patients, 60 (24%) underwent CGP testing. Druggable genomic alterations were identified in 45 patients (75%), and seven patients (12%) received genomically matched therapy. Of these, 5% were treated within clinical trials, and 7% received approved targeted agents. Among patients who received matched therapy, the best overall response was complete response (CR) in two, partial response (PR) in two, stable disease (SD) in one, and progressive disease (PD) in two. Tumor-type-stratified analyses showed variability in actionable/druggable profiles and matched-therapy delivery across tumor types. No significant difference in OS was observed between the CGP and non-CGP groups (median OS: 22.9 vs. 23.0 months, P = 0.78). Within major tumor types, including colorectal, gastric, pancreatic, and biliary tract cancers, OS did not significantly differ according to CGP testing status. Among CGP patients, OS tended to be longer in those who received matched therapy, although the difference was not statistically significant.

Conclusions

Despite being conducted in a community hospital outside the cancer genomic core network, CGP testing was feasible and enabled a clinically meaningful proportion of patients to access genome-matched therapy at rates comparable to those reported from tertiary centers. Although CGP did not directly translate into improved OS, it provided valuable treatment opportunities and facilitated precision oncology in a regional care setting. Further expansion of accessible genome-guided therapies may enhance the clinical impact of CGP in community hospitals.

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