Broad Genomic Sequencing Extends Advanced Lung Cancer Survival

Broad genomic sequencing extended overall survival in advanced non-small cell lung cancer patients by an average of two months when performed before first-line treatment.

The research, published in the November 2026 issue of the JNCCN-Journal of the National Comprehensive Cancer Network, analyzed real-world data from the Flatiron Health Research Database. The study examined more than 35,000 patients treated across community and academic oncology practices in the United States between 2016 and 2022.

Patients who received broad-based genomic sequencing—testing a large panel of dozens or hundreds of genes at once—faced improved progression-free survival compared with patients who received limited biomarker testing of just one or two genes. The broader testing helped identify a wider range of tumor biomarkers capable of guiding targeted treatment.

According to the study, 19% of broad-based genomic sequencing recipients received targeted therapy, compared to 16% of patients 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, MD, MPP, from the 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 for Non-Small Cell Lung Cancer recommend broad-based genomic sequencing in the advanced or metastatic setting. Common biomarkers such as EGFR, ALK, ROS1, KRAS G12C, MET, RET, and BRAF assist doctors in matching patients to targeted therapies that work better and feature easier tolerability.

“While it may seem obvious that broad genomic sequencing of tumors leads to the use of more targeted therapies and ultimately better outcomes compared to focused biomarker testing, this can be difficult to prove without large numbers of patients from multiple different health systems over long periods of time.”

observed Heather Hampel, MS, CGC, Associate Director, Division of Clinical Cancer Genomics, City of Hope, who did not take part in the study.

By leveraging electronic health records, this research demonstrates that comprehensive genomic profiling correlates with enhanced survival rates among individuals with advanced non-small cell lung cancer, while also driving increased administration of biomarker-guided targeted treatments in the matched first-line evaluation relative to targeted panel testing. This also avoids use of other therapies that may be less effective or even harmful.

Lead author Patricia Mae G. Santos, MD, MS, from the Emory University School of Medicine and Winship Cancer Institute concluded,

“Coverage should match the evidence; we need to make sure that access to that testing doesn’t depend on insurance, provider, or location. And if you or someone you love is diagnosed with advanced lung cancer, ask your care team one question before treatment starts: ‘Has my tumor had comprehensive biomarker testing?'”