Landscape and Time Course of Comprehensive Genomic Profiling Use in Japanese Patients With Cancer: A Retrospective Study

ABSTRACT

Comprehensive genomic profiling (CGP) is standard for advanced solid tumors. Evidence reporting its real‐world utilization pattern and time course for guided therapy is limited. This retrospective study in Japan assessed the real‐world utility of CGP tests for advanced or metastatic solid tumors using data from the C‐CAT registry from June 1, 2019, to August 23, 2025. We evaluated the proportion of patients who received genomically matched therapy with expert panel (EP) recommendation and their overall survival (OS) compared with patients who did not receive genomically matched therapy. The study population comprised 89,552 patients who underwent CGP: median age 64.0 (interquartile range: 54.0–72.0) years, with pancreatic cancer (13,827; 15.4%) and colorectal cancer (11,322; 12.6%) the most common tumor types. System‐generated matched treatment options presented as reference information during EP review were identified in 80,185, of whom 77,337 (96.4%) received EP review, 37,245 (46.4%) were offered new therapeutic recommendations, and 7124 (8.9%) initiated EP‐recommended therapies. Among 2049 patients who were newly identified with companion diagnostic (CDx)‐related druggable alterations, 319 (15.6%) received matched therapies. Patients receiving matched therapies experienced longer OS compared with others in the overall cohort (median: 538 days vs. 356 days) and across cancer types. OS varied by the final treatment line before CGP testing, with earlier lines associated with longer survival in biliary tract, ovarian, pancreatic, and thyroid cancers. These findings highlight the need for timely CGP implementation to maximize the impact of precision oncology.

Trial Registration: Japan Registry of Clinical Trials identifier: jRCT1030250365