Clinical Utility of Comprehensive Genomic Profiling for Advanced Pancreatic Cancer: Insights from Real-World Data Analysis

Background Precision medicine is a promising therapeutic strategy for pancreatic cancer. However, only a few patients are eligible for genotype-matched treatments because of the low detection rate of actionable genomic alterations, and the clinical application of comprehensive genomic profiling (CGP) in pancreatic cancer has not been completely investigated. CGP provides considerable information, such as data on prognosis and future eligibility of patients for genotype-matched clinical trials, and can eventually guide physicians’ treatment strategies. This study aimed to investigate the contribution of CGP to patient outcomes. Methods This single-center retrospective cohort study enrolled patients diagnosed with recurrent or metastatic pancreatic cancer with adenocarcinoma or adenosquamous carcinoma who underwent systemic chemotherapy between April 2018 and April 2022. We reviewed medical records and collected data on patient characteristics, survival, and genomic information. We compared overall survival (OS) between patients who received CGP (CGP group) and those who did not (non-CGP group). Results Overall, 111 patients were eligible, of which 59 underwent CGP. No significant differences were observed in patient characteristics between the groups. The median OS was significantly longer in the CGP group than in the non-CGP group (25.2 vs. 11.8 months; hazard ratio, 0.49; 95% confidence interval, 0.31–0.76; P  = 0.0013). Actionable genomic alterations were detected in 24 patients (40.7%), and six patients (10.2%) underwent genotype-matched treatments. Conclusions OS was extended in patients with pancreatic cancer who underwent CGP, possibly due to its influence on physicians’ treatment strategies. This result highlights the need for proactive and timely CGP for patients with pancreatic cancer.