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New research in the November 2026 issue of Journal of the National Comprehensive Cancer Network found that patients with advanced non-small cell lung cancer (NSCLC) lived longer when they received broad-based genomic sequencing (BGS)—testing a large panel of dozens or hundreds of genes at once—before starting treatment, compared with patients who received more limited biomarker testing of just one or two genes.
The study analyzed real-world data from the Flatiron Health Research Database, including more than 35,000 patients treated in community and academic oncology practices across the United States from 2016 to 2022. BGS before first-line therapy was associated with a two-month average increase in overall survival and modest improvement in progression-free survival, likely because it helped identify a wider range of tumor biomarkers that could guide targeted treatment. According to the study, 19% of BGS recipients received targeted therapy, compared with 16% of those in the narrow testing group.
"Our findings and prior work suggest broad-based genomic testing should be the default for patients with advanced lung cancer and should ideally happen prior to the administration of first-line therapy," said co-senior author Ravi B. Parikh, M.D., M.P.P., of Emory University School of Medicine and Winship Cancer Institute. "The right test, done early, can open doors to treatments that might otherwise be missed."
The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Non-Small Cell Lung Cancer recommend BGS in the advanced/metastatic setting.
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