MAP of molecular analyses in real-worlD oncology centers – MAPpaMoNDO: a study of the translational research Young GOIM group

Despite the growing number of potential predictive biomarkers, molecular testing in daily oncology practice remains fragmented. The GOIM Young Translational Group conducted a survey to map the molecular testing prescription habits of oncologists across diverse Italian institutions. The survey evaluated general practices and specific tumor types—including gastrointestinal, lung, breast, genitourinary, gynecological, melanoma, and cancer of unknown primary (CUP)—exploring variations in testing frequency, technology, timing, and sample types between academic and non-academic institutions. We also evaluated logistical differences between center types and specific topics of interest, such as Next-Generation Sequencing (NGS) implementation, re-biopsy of new lesions, liquid biopsy timing/access and BRCA testing. Sixty-three responses were collected from 46 institutions, spanning diverse geographical regions and institution types. Molecular analyses are performed entirely in-house in only 40% of cases overall. A marked institutional gap emerged: 60% of academic centers perform all testing internally, compared to just 20% of non-academic centers. Academic centers also demonstrated higher participation in external quality control programs (70% vs. 50%) and more frequently served as regional hubs (60%). Furthermore, a pronounced difference was observed in hereditary cancer testing: in-house germline BRCA1/2 testing for breast cancer is available in 81% of academic institutions compared to only 13% of non-academic centers. Access to liquid biopsy varied across tumor types and center settings. In colorectal cancer, 35.7% of all institutions reported a lack of access, with non-academic centers experiencing a higher rate of non-accessibility (47.8% vs. 21.0% academic), highlighting structural disparities across practice settings. This survey provides an overview of current molecular testing practices for solid tumors among a cohort of selected Italian oncology institutions, revealing stark disparities between academic and non-academic centers. While patient-level clinical endpoints, turnaround times, and costs were not directly measured, addressing these institutional variations and supporting patient access to precision oncology will benefit from coordinated nationwide policy harmonization, structural investments in non-academic laboratory infrastructure, and the formalization of managed hub-and-spoke networks.