Broader Genomic Testing Opens New Treatment Paths in Solid Tumors

A prospective Canadian study suggests that moving beyond narrow, cancer-specific molecular panels toward broader genomic profiling can meaningfully expand the treatment options available to patients with advanced solid tumors, while also generating measurable savings and efficiencies for provincial health systems.^1,2

Researchers at London Health Sciences Centre Research Institute (LHSCRI) led the Precision Oncology at Western University (POWER) study, described as the first prospective Canadian trial to evaluate how expanded pan-cancer next-generation sequencing (NGS) affects real-world oncology decision-making.¹ The findings, published in the Journal of Molecular Diagnostics, followed 554 patients with advanced solid tumors spanning gastrointestinal, lung, head and neck, breast, gynecologic, genitourinary, brain and nervous system, sarcoma, skin, and unknown-primary malignancies treated at London Health Sciences Centre (LHSC)'s Verspeeten Family Cancer Centre.^1,2

Unlike standard-of-care testing, which typically interrogates a limited set of genes tied to a single tumor type, the NGS panel used in POWER screens hundreds of cancer-related genes at once, capturing alterations that narrower assays often miss.¹ Investigators reported that 79% of patients carried at least 1 clinically relevant variant, and nearly 28% became newly eligible for treatment after identification of a previously undetected druggable mutation.¹

Trial Access and Off-Label Therapy Gains

“This study is one of the first to show, in real-world settings, that broader testing can find important changes in a tumor's DNA and help identify alternative treatment options,” Bekim Sadikovic, PhD, scientist at LHSCRI, head of the Verspeeten Clinical Genome Centre, and senior author of the study, stated in a news release. “In almost 1 in 3 patients we tested, we found changes in their DNA that would make them eligible for different therapies that may be more effective than the standard of care.”²

The expanded testing translated directly into clinical decisions. Eighteen percent of participants gained access to clinical trials or off-label therapy anticipated to produce better outcomes than conventional treatment.¹ Among a subset of 162 patients who had already undergone tumor-specific panel testing, 19% (31 patients) had their management altered once results from the broader panel became available, a gap the authors say points to the limits of narrower testing strategies.¹

“Accessing off-label drugs, which are treatments approved for one use but not another, is often challenging,” Sadikovic said. “However, when there is strong evidence that a specific therapy is likely to work for an individual patient, it can help open the door to access and has the potential to transform cancer care.”²

Health System and Practice Impact

Beyond individual treatment decisions, the research team identified downstream effects on the broader health care system. Safer treatment options became available for 14.5% of patients, a shift that could reduce treatment-related morbidity, while 17.6% of patients experienced an overall change in management and 17.3% had their treatment sequence reordered so that the most appropriate therapy was given at the optimal time.^1,2 Earlier identification of effective therapies also helped avoid the later use of costlier drugs funded through the provincial formulary in 12.5% of cases.^1,2

“I meet with patients every day whose only remaining options are compassionate access to a specific drug or enrollment in a clinical trial,” Stephen Welch, MD, scientist at LHSCRI and medical oncologist at LHSC, stated in the news release.² “This kind of evidence helps us make more informed decisions, so patients are not asked to endure treatments that are unlikely to help and instead are guided toward options with real potential.”

The POWER investigators note that patient enrollment and data collection are ongoing, with plans to further characterize how expanded genomic testing affects long-term outcomes and system-level costs across Ontario.² The work is conducted through the Verspeeten Clinical Genome Centre, established in 2020 through a philanthropic gift from the late Archie and Irene Verspeeten and described as the first program of its kind in Canada to combine this scale of genomic diagnostics with personalized treatment matching. ²

“Our team is building real-life evidence that this genomic testing is making a difference in the lives of patients with cancer and has a true positive impact on our health care system,” Welch said. “It's the future of precision medicine and the future of cancer care that we are really excited about.” ²

References

1. Health care impact of comprehensive genomic profiling of solid tumors in patient management using POWER (Precision Oncology at Western University). J Mol Diagn. 2026;28(4):354-365.

2. London Health Sciences Centre Research Institute. New study shows expanded genetic testing helps match cancer patients to more personalized treatment options. Published on online August 17, 2026. Access August 30, 2026. https://tinyurl.com/4d2pcdtk