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TOPLINE:

Broad genomic profiling was used in only 1 in 4 US patients with newly diagnosed metastatic cancer between 2020 and 2022, a new study reported. Although testing rates increased over this time period, they remained under 50%, even in cases where broad genomic profiling is explicitly recommended by guidelines.

METHODOLOGY:

• The use of broad genomic profiling has been increasing in cancer care, but its uptake across diverse patient populations has been difficult to evaluate due to challenges in claims-based tracking of its use.
• A serial cross-sectional study analyzed 51,908 privately insured US patients (median age, 57 years; 63.1% women) diagnosed with one of the 10 most common metastatic solid malignant neoplasms. Data came from a national healthcare claims database between January 2020 and June 2022.
• Researchers developed a claims-based algorithm to identify the use of broad genomic profiling through specific codes and billed stack codes, where broad genomic profiling was represented by 10 or more single-gene test codes, or unspecified molecular testing codes.

TAKEAWAY:

• Among those included in the study, 20.3% underwent broad genomic profiling.
• Overall genomic profiling rates increased from 15.1% to 24.3% between 2020 and 2022, with metastatic pancreatic cancer showing the highest absolute increase of 21.7%.
• But the uptake remained under 50% overall, even for cancer types where broad genomic profiling was explicitly recommended by guidelines. Across these cancer types, uptake ranged from a high of 49.0% in metastatic lung cancer to a low of 8.8% in metastatic breast cancer.
• For cancers with equivocal recommendations, the uptake of broad genomic profiling varied from 36.1% in metastatic colorectal cancer to 3.7% in metastatic thyroid cancer.
• Older age (odds ratio [OR], 0.48; age, ≥ 80 years), frailty (OR, 0.80), female sex, and non-Northeastern geographic areas were factors associated with a lower likelihood of receiving broad genomic profiling.

IN PRACTICE:

“Notably, [broad genomic profiling] use was still suboptimal in all groups, and we identified additional factors associated with disparate uptake,” the authors wrote. 

“Our data build on and are consistent with trends of increasing [broad genomic profiling] use reported in prior work, supporting the accuracy and utility of our ascertainment algorithm,” they added.

SOURCE:

The study, led by Xiao Wang, MD, Yale School of Medicine, New Haven, Connecticut, was published online in JAMA Oncology.

LIMITATIONS:

Study limitations included lack of specificity in histologic analysis and the use of a privately insured population, as well as broader limitations inherent to claims-based retrospective studies.

DISCLOSURES:

This study was supported by a grant from the National Institutes of Health. Several authors reported receiving grants or having other ties with various sources.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.