Broad genomic profiling (BGP) is an advanced oncology tool that examines multiple genes in a tumor sample simultaneously, providing a comprehensive genetic analysis to identify targeted therapies for cancer patients. A recent study by researchers at the Yale School of Public Health (YSPH) highlighted that despite its potential medical benefits, BGP remains underused across the United States, particularly in patients with common metastatic cancers such as lung, pancreatic, melanoma, and breast cancer, where the test is explicitly recommended by the National Comprehensive Cancer Network (NCCN). Published in JAMA Oncology, the study analyzed data from a large Blue Cross Blue Shield health insurance claims database, focusing on over 50,000 U.S. patients diagnosed with the 10 most common metastatic cancers between 2020 and 2022. The researchers tracked BGP usage within six months of diagnosis. Over the study period, BGP use increased, rising from 15.1% of patients in early 2020 to 24.3% by mid-2022. However, even with this growth, the test was underutilized, with fewer than half of the patients in most cancer categories receiving it. Lung cancer had the highest BGP usage, at 49%, which is still lower than expected, given the standard of care recommendations. The study revealed significant disparities in BGP testing. Patients who were older, identified as female, lived outside the Northeast, or were considered frail were less likely to undergo BGP. According to Dr. Michaela Dinan, senior author and associate professor of chronic disease epidemiology at YSPH, older patients often have competing health issues that may influence the decision to pursue aggressive treatment options. Conversely, the lower use among female patients and those living in non-Northeast regions was unexpected and requires further investigation. BGP offers several advantages over traditional single-gene testing methods. It can detect multiple gene alterations simultaneously, guiding doctors to more precise and targeted treatments, including identifying eligible patients for clinical trials. In lung cancer, where BGP is particularly critical, nearly a dozen targeted therapies are available, making it essential for determining the most effective treatment plan. For breast cancer, BGP is more commonly used for second-line treatment decisions, helping to refine therapeutic strategies based on genetic mutations. However, BGP has its drawbacks, primarily its higher cost and longer turnaround time compared to single-gene tests. Dr. Xiao Wang, the lead author and a clinical fellow in medical oncology and hematology at Yale School of Medicine, acknowledged these challenges but emphasized the importance of improving access and efficiency to make BGP a viable option for more patients. He noted that some oncologists might opt for quicker, single-gene tests if immediate treatment decisions are necessary, or if a patient is not likely to benefit from the comprehensive analysis provided by BGP. While the study focused on privately insured patients, the findings suggest a broader issue with the adoption of BGP in cancer care. Future research will delve into the impact of BGP on treatment outcomes and its cost-effectiveness, which could provide valuable insights for policymakers and healthcare providers. Industry insiders and experts agree that BGP holds significant promise but faces practical hurdles. Dr. Wang suggests that as BGP becomes faster and more cost-effective, its utility will grow, potentially becoming a standard component of cancer care. Yale Cancer Center, a leader in cancer research and treatment, plays a crucial role in advancing this technology and addressing the barriers to its widespread adoption. Improved access and streamlined processes are essential steps toward ensuring that more patients can benefit from this powerful tool.