Somatic Genomic Testing for Metastatic or Advanced Cancer

Document Overview

Document Title

Somatic Genomic Testing in Patients with Metastatic or Advanced Cancer

Authoring Society

American Society of Clinical Oncology

Document Publication Date

Feb 16, 2022

Page Last Reviewed/Updated

May 5, 2026

Document Type

Guideline

Country of Publication

United States

Full Text Freely Available

Yes

Full Text Guideline

ascopubs.org/doi/full/10.1200/JCO.21.02767

Source Citation

Chakravarty D, Johnson A, Sklar J, et al. Somatic Genomic Testing in Patients with Metastatic or Advanced Cancer: ASCO Provisional Clinical Opinion. J Clin Oncol. 2022 Feb 17. doi:10.1200/JCO.21.02767

Supplemental Implementation Resources

• PPS
• PDF
• Visual Abstract
• Quick-Reference Guide
• Podcast
• Patient Information

Document Scope, Criteria, and Use Cases

Document Objectives

An ASCO provisional clinical opinion offers timely clinical direction to ASCO's membership following publication or presentation of potentially practice-changing data from major studies. This provisional clinical opinion addresses the appropriate use of tumor genomic testing in patients with metastatic or advanced solid tumors.

Scope

Assessment and Screening, Diagnosis

Diseases/Conditions (MeSH)

D014408 - Biomarkers, Tumor

D000088744 - Genomic Medicine

D014408 - Biomarkers, Tumor

D000088744 - Genomic Medicine

Keywords

Somatic Tumor Testing, genomic

Target Patient Population

Patients with metastatic or advanced solid tumors

Target Provider Population

Oncologists, pathologists, and other clinicians involved in deciding appropriate care for patients with metastatic or advanced cancer

Inclusion Criteria

Male, Female, Adolescent, Adult, Child, Older Adult

Health Care Settings

Hospital, Laboratory Services, Outpatient

Intended Users

Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

PICO Questions

1. For what clinical scenarios are there biomarker-linked regulatory approvals for the treatment of specific genomic alterations?
2. When should multigene panel–based genomic testing be performed when there is only a single genomic biomarker or small numbers of genomic biomarkers linked to regulatory approvals of anticancer drugs?
3. What are other important considerations when ordering and interpreting genomic testing?
4. What is the role of multigene panel–based tumor genomic sequencing in dMMR and/or microsatellite instability-high testing?
5. What is the role of multigene panel–based tumor genomic sequencing in TMB testing?
6. When should patients be tested for fusions?
7. When should patients be tested for fusions outside of disease-specific approvals?
8. What evidence of actionability should be present for a clinician to recommend a therapy on the basis of panel testing in the absence of approved indications?

Supplemental Methodology Resources

Data Supplement Evidence Tables

Number of Source Documents

220

Includes peer/external review process?

Yes

Includes public comment process?

Yes

Methodologist involvement?

Yes

Patient involvement?

No

Includes multi-disciplinary group?

Yes

Includes systematic review?

Yes

Grades quality of strength of evidence?

Yes

Grades quality of strength of recommendation?

Yes

Discloses funding source?

Yes

Discloses conflicts of interest?

Yes

Includes benefits/harms analysis with recommendations?

No