{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:50:52Z","timestamp":1791352252978,"version":"4.3.1"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Advances in molecular and cell biology have led to a paradigm shift in cancer management. We implemented next\u2010generation sequencing (NGS) at our community\u2010based academic cancer center over a decade ago. We sought to optimize the use of genomics and understand its impact in identifying actionable genomic alterations to determine therapy options in patients with advanced solid tumors for whom standard therapies had been exhausted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Through a prospective non\u2010randomized trial, patients with advanced solid tumors who had exhausted standard therapies and who did not qualify for routine guideline\u2010concordant NGS at the time of the study (the study excluded at least Stage 1B lung and Stage IV colorectal cancers) underwent in\u2010house NGS on tumor specimens to identify actionable alterations, and pharmacogenomic testing. Our in\u2010house\u2010developed\/integrated bioinformatics pipeline (Flype) was used for structured reporting and served as a molecular knowledgebase. Patients were presented at a multidisciplinary molecular tumor board.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>251 patients underwent somatic tissue NGS. 173 patients (68.9%) had alterations targetable with FDA\u2010approved or currently investigational drugs. 75 patients (29.9%) had alteration(s) qualifying them for FDA\u2010approved drug(s) for their tumor type. An additional 61 patients (24.3%) had alterations qualifying them for \u201coff\u2010label\u201d use of FDA\u2010approved drugs. 40 patients (15.9%) qualified for tumor\u2010agnostic therapies. Of the 224 patients (89.2%) who had RNA analysis, eight (3.6%) had targetable fusions. Of the 33 patients (19.1%) who received NGS\u2010guided targeted therapies, 19 (57.6%) were on treatment for longer than three months. 255 patients underwent pharmacogenomics testing, with over 40% having an alteration in typical response to opioids or antidepressants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this real\u2010world study, 54.2% of patients with advanced solid tumors were identified as candidates for FDA\u2010approved therapies (on\u2010 or off\u2010label), supporting the utility of in\u2010house NGS in providing genomics\u2010guided care for patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72355","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:18:17Z","timestamp":1791350297000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Next\u2010Generation Sequencing\u2010Based Molecular Profiling and Management of Advanced Solid Tumors: A Real\u2010World Experience in a Community\u2010Based Academic Cancer Center"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7917-7075","authenticated-orcid":false,"given":"Gayathri","family":"Moorthy","sequence":"first","affiliation":[{"name":"Neaman Center for Personalized Medicine  Evanston Illinois USA"},{"name":"NorthShore Division of Hematology\/Oncology Endeavor Health Cancer Institute  Evanston Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Sereika","sequence":"additional","affiliation":[{"name":"Neaman 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