Retrospective analysis of real-world clinical use of comprehensive genomic profiling in solid tumors in Finland 2017-2020

Background Precision oncology has developed significantly during the last decade. To understand and describe the use of genomic profiling for cancer patients, we carried out a retrospective study in Finland. Materials and methods The study included 297 patients who underwent comprehensive genomic profiling (CGP) as part of their clinical care during 2017-2020. In addition to the genomic data, relevant background and clinical information were gathered from the patient records. Additionally, the actionability of the test results, clinical response and survival were evaluated. Results Most patients had either prostate (16.8%), breast (14.8%), or pancreatic cancer (11.8%). The majority of the patients had metastatic disease (85.8%) and had median age of 61 years. Patients were heavily pretreated, with 51.3% having received three or more treatment lines before CGP testing. Of the patients, 65.2% had at least one actionable alteration in their samples. The treatment decision was based on the CGP test result for 25.6% ( n = 76) of the patients. The main reason for not giving CGP-guided treatment was the lack of clinically significant alterations based on the clinician's judgment. Explorative survival analysis suggested variation across different ESMO Scale for Clinical Actionability of Molecular Targets tiers. It also indicated that a higher number of treatment lines before CGP testing and decreased performance status at testing were associated with poor survival. Conclusions This study provides a descriptive analysis of the clinical and genomic characteristics of the Finnish CGP-cohort and explores the clinical outcomes. The results align with recent findings from other European countries and provide a context for ongoing prospective studies.