Link Between Comprehensive Genomic Profiling and Targeted Therapy Usage Highlighted by Recent Study, Medicare Patients Show Lower Testing Rates

Recent research conducted by Optum and Illumina Inc. has revealed significant gaps in biomarker testing among patients with advanced cancers in the United States. Despite clear clinical guidelines recommending genomic assessments to guide personalized treatment, less than half of newly diagnosed advanced cancer patients undergo any form of biomarker testing prior to starting therapy. This deficiency persists across different healthcare plans, with patients enrolled in Medicare Advantage plans testing at notably lower rates compared to those covered by commercial insurance.

The study, titled "Biomarker Testing Approaches, Treatment Selection, and Cost of Care Among Adults With Advanced Cancer," analyzed data from 26,311 adults diagnosed between 2018 and 2022 through the Optum Labs Data Warehouse, covering both commercial and Medicare Advantage populations. Researchers categorized patients based on their biomarker testing activity within 90 days before systemic treatment initiation into three groups: no testing, non-comprehensive gene panel (non-CGP) testing, and comprehensive genomic profiling (CGP).

Findings highlighted that overall biomarker testing rates hovered around 35%, increasing slightly to 39% in 2021-2022. For example, in non-small cell lung cancer, 45% of patients were tested initially, with only 22% undergoing CGP. Ovarian cancer had the lowest testing rates, with only 17% being evaluated genetically. Testing trends showed modest improvement over time, particularly with CGP usage rising from 12% in 2018 to 33% in recent years among lung cancer patients.

Importantly, undergoing CGP was strongly associated with increased likelihood of receiving targeted therapies. Patients with CGP were over three times more likely to start on targeted treatments compared to those without biomarker testing. Similar patterns were observed in colorectal and small cell lung cancer cases. Cost analyses demonstrated no significant difference in monthly treatment expenses between patients who received CGP and those who did not, indicating that broader testing could be incorporated without adding financial burden.

However, a persistent disparity was identified: Medicare Advantage enrollees were less likely to undergo biomarker testing compared to those with commercial insurance, a gap that remained stable throughout the study period. While testing rates increased across all insurance groups, Medicare patients consistently lagged behind.

The study concludes that although there has been progress in integrating comprehensive genomic testing into clinical practice, the majority of patients still do not receive guideline-recommended biomarker assessments before initiating therapy. Expanding the adoption of CGP may enhance treatment alignment with clinical guidelines, improve patient outcomes through personalized therapies, and do so without increasing overall healthcare costs. This underscores the importance of healthcare policies aimed at increasing testing access, particularly among Medicare populations, to promote precision medicine in oncology.

Source: https://medicalxpress.com/news/2025-07-comprehensive-genomic-profiling-linked-higher.html