Turnaround Time of Comprehensive Genomic Profiling in Lung Cancer and Other Solid Tumors

PURPOSE Given the importance of timely comprehensive genomic profiling (CGP) for the treatment of cancer, this study aimed to provide generalizable estimates of turnaround time (TAT) for tissue-based CGP. Secondary aims were to identify TAT trends over time and explain variation based on clinical, demographic, and administrative factors. METHODS Data for solid tumor samples profiled from 2018 through 2024 from a commercial laboratory were analyzed. Descriptive statistics were used to summarize and compare TAT between sites. Linear regression was used to assess for yearly trends and to measure associations between clinical, demographic, and administrative variables and TAT. RESULTS A total of 271,574 solid tumor malignancies originating from 5,497 clinical sites were included in the analysis. The overall TAT (specimen collection to CGP results reporting) decreased from a median of 43 days (IQR, 31-72) to 32 days (IQR, 22-51) from 2018 to 2024. When comparing overall TAT for 2024 by clinical site, the shortest and longest overall TAT quintiles were 23.1 days (IQR, 20.6-24.6) and 46.5 days (IQR, 42.7-50.8), respectively ( P < .001). There was variability in timeliness of ordering between sites with a median time from biopsy to CGP ordering of 10.0 days (IQR, 8.0-12.0) versus 30.8 days (IQR, 26.6-35.0) for the shortest and longest quintiles, respectively. Factors associated with shorter ordering and overall TAT included, but were not limited to, higher clinical site ordering volumes, cancer type, and ordering method. CONCLUSION Delay in the time from biopsy to CGP ordering was the largest contributor to protracted TAT and varied between clinical sites. Increasingly, the appropriate treatment of cancer is dependent on biomarker testing and delays in testing likely contribute to suboptimal patient care.