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We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: Time from biopsy to receipt of molecular testing results decreased, but most of the improvement occurred at the laboratory level. Clinical sites must streamline processes to ensure even shorter turnaround time. The time between biopsy and ordering of tissue-based comprehensive genomic profiling varies widely between clinical sites, according to study results. Delays during this period are the largest contributor to prolonged turnaround time for molecular testing results, which are crucial to inform treatment decisions for people with cancer.
Data derived from Fox AH, et al. JCO Oncol Pract. 2026;doi:10.1200\/OP-25-01191.
Adam H. Fox \u201cI would urge anyone working as part of a multidisciplinary team in oncology care to not assume that this testing is happening as quickly as they would hope,\u201d Adam H. Fox, MD, MS, lung cancer pulmonologist at Medical University of South Carolina\u2019s Hollings Cancer Center, told Healio. \u201cIt is very important for them to look at internal data to see how long this process is taking, talk to corresponding specialists \u2014 from the ones helping to obtain biopsies to the ones who are using molecular testing results \u2014 and identify ways to streamline the process and ensure patients receive optimal care.\u201d \u2018How long is it taking?\u2019 Multiple guidelines recommend comprehensive genomic profiling for patients with advanced or metastatic solid tumors to identify individuals who may benefit from precision therapies, such as immunotherapy or targeted agents. Prior research suggests testing is underutilized in oncology. It also may be performed late. A study presented at last year\u2019s ASCO Annual Meeting showed one-quarter of patients with common cancers who underwent testing received results within 3 months of death. However, data regarding turnaround time for comprehensive genomic profiling are limited, according to study background. Much of the prior work examining this issue in lung cancer \u2014 in which the selection and timing of initial treatment largely depends on biomarker testing \u2014 has been conducted at single centers, and data have not been generalizable to broader populations. \u201cIdeally, we want to have these test results before we make any decisions,\u201d Fox said. \u201cWe know selecting the right treatment first can improve outcomes, but there is a pressure to start therapy on the part of both oncologists and patients. There is a limit to how long they are willing to wait, and it varies from person to person. We cannot simply ask, \u2018Is testing getting done?\u2019 We also need to ask, \u2018How long is it taking?\u2019\u201d A \u2018frustrating\u2019 finding Fox and colleagues sought to estimate turnaround time \u2014 from specimen collection to reporting of comprehensive genomic profiling results \u2014 for tissue-based testing across the United States. They also aimed to identify factors that contribute to variation in turnaround time in hopes of identifying interventions to minimize delays. Researchers analyzed data for all solid tumor samples on which FoundationOne CDx tissue-based comprehensive genomic profiling had been completed successfully from 2018 through 2024. Their analysis included 271,574 specimen samples that originated from 5,497 clinical sites across the country during that 7-year period. The most common cancer types included non-small cell lung cancer (23.1%), colorectal cancer (12.5%), pancreatic\/biliary cancer (10.1%) and breast cancer (10%). Most tests had been ordered through manual methods (51.8%) \u2014 such as paper forms, fax or email \u2014 or an online portal (42.2%). Another 6% of tests had been ordered through electronic health record integration. Turnaround time for all cancer types declined from a median 43 days (interquartile range [IQR], 31-72) in 2018 to 32 days (IQR, 22-51) in 2024. An analysis by cancer type showed the shortest turnaround time for NSCLC samples. It declined from a median 36.6 days (IQR, 27.9-51.6) in 2018 to 27 days (IQR, 19.5-39.9) in 2024. Fox said he was \u201cpleasantly surprised\u201d to see these decreases but noted much of the improvement has been due to streamlined processes at the molecular laboratory, which shortened the time between sample receipt and availability of results. For example, molecular laboratory turnaround time for NSCLC samples declined from a median 15.2 days (IQR, 13.5-17.3) in 2018 to 7.1 days (IQR, 6.2-8.1) in 2024 (P = .009 for comparison). \u201cThat is a great win, but the time between biopsy and placing the testing order did not change over the study period,\u201d Fox said. \u201cTo see no real improvement over time in that area was really frustrating.\u201d Turnaround time from biopsy to test result availability varied greatly between clinical sites. The analysis of all tumor types showed the fastest quintile of sites had a turnaround time of 23.1 days (IQR, 20.6-24.6), compared with 46.5 days (IQR, 42.7-50.8; P < .001 for comparison) in the longest quintile of sites. The analysis limited to NSCLC samples showed the fastest quintile of sites had a turnaround time of 19.5 days (IQR, 16.7-20.6), compared with 38.9 days (IQR, 35.3-41.8; P < .001 for comparison) in the longest quintile of sites. Meanwhile, median time from biopsy to comprehensive genomic profiling ordering for all samples ranged from 10 days (IQR, 8-12) in the shortest quintile to 30.8 days (IQR, 26.6-35) in the longest quintile. Median time from biopsy to test ordering for NSCLC samples ranged from 8 days (IQR, 6.8-9.1) in the shortest quintile to 23.8 days (IQR, 21-28.3) in the longest quintile (P < .001 for comparison). \u201cThis is the longest component of the process but, the good news is, it also is the most modifiable,\u201d Fox said. Downstream bottlenecks Multiple factors \u2014 including higher ordering volume at a clinical site, use of electronic methods to order testing and younger patient age \u2014 appeared associated with shorter turnaround time. Turnaround time<\/p>\n","protected":false},"author":1,"featured_media":2958,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2957","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/2957","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2957"}],"version-history":[{"count":0,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/posts\/2957\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=\/wp\/v2\/media\/2958"}],"wp:attachment":[{"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2957"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2957"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoniafawad.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2957"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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