Transforming patient care in oncology: Nationwide results of comprehensive genomic profiling–guided therapy in everyday clinical practice.

Abstract

e23420 Background: In recent years, precision medicine has become one of the most thought-provoking concepts in healthcare, especially in oncology, fundamentally transforming the way patient care is delivered. Recent advancements in sequencing technologies have substantially reduced the costs associated with comprehensive genomic profiling (CGP), facilitating its integration in routine practice. Also, innovative treatment strategies have already produced remarkable improvements in outcomes for several cancer types. However, with ambiguous results from clinical trials, the importance of real-world data is increasingly recognized. As a further development of our previously published CGP analyses, we present the CGP-guided treatment results at the national level for the first time. Methods: The study was retrospective, conducted at the country level among all patients who were administered with CGP-guided therapy from January 1, 2020, to December 31, 2025. The analysis was performed in an accredited laboratory (Foundation Medicine Inc., Cambridge, MA, USA or Personalized Medicine Department, UHC Zagreb, Croatia). Patients were administered with CGP-guided therapy following recommendations from Multidisciplinary Tumor Board (MTB) either in later-line settings (95%), or when first-line reimbursement was not available (5%). Progression-free survival (PFS) was measured from the initiation of either CGP-guided to the occurrence of disease progression, death from any cause, or the most recent follow-up (with data censored accordingly), whichever event transpired first. Results: There was a total of 4150 of tested patients, out of whom 339 (8%) patients were treated according to their CGP results. Median age was 63 years (IQR 53-69), and 58% of patients were women, while 42% were men. Most commonly treated were lung (16%), uterine (12%), ovarian (11%), breast (11%), and colon (9%) cancer. Median number of previous lines was 2 (IQR 1-3), with 29% of patients who received at least 3 lines of therapy. The most common therapy administered was olaparib in 63 (18.5%) patients, following were pembrolizumab and trastuzumab-deruxtecan in 50 (14.7%) and 31 (9.1%) patients, respectively. Median progression-free survival (PFS) was 4.7 months (IQR 2.1-10.6). The data were missing for 4 (1.2%) patients, and they were excluded from analysis. Notably, 43% achieved PFS > 6 months and 21% exceeded 12 months, with 10.5% surpassing 18 months. As of January 25, 2026, 41.9% remained on therapy without progression. Conclusions: Our results have shown that despite a heavily pretreated, refractory population of patients, a mPFS of 4.7 months and 21% of patients exceeding 12 months PFS defines potential and value of precision medicine approach in oncology. Given the time elapsed since data collection and the inclusion of recently treated patients, an updated data analysis is warranted.