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In this study, we developed an in\u2010house clinical sequencing system to perform a comprehensive cancer genomic profiling test as a clinical examination and analyzed the utility of this system. Genomic DNA was extracted from tumor tissues and peripheral blood cells collected from 161 patients with different stages and types of cancer. A comprehensive targeted amplicon exome sequencing for 160 cancer\u2010related genes was performed using next\u2010generation sequencing (NGS). The sequencing data were analyzed using an original bioinformatics pipeline, and multiple cancer\u2010specific gene alterations were identified. The success rate of our test was 99% (160\/161), while re\u2010biopsy was required for 24% (39\/161) of the cases. Potentially actionable and actionable gene alterations were detected in 91% (145\/160) and 46% (73\/160) of the patients, respectively. The actionable gene alterations were frequently detected in <jats:italic>PIK3CA<\/jats:italic> (9%), <jats:italic>ERBB2<\/jats:italic> (8%), and <jats:italic>EGFR<\/jats:italic> (4%). High tumor mutation burden (TMB) (\u226510 mut\/Mb) was observed in 12% (19\/160) of the patients. The secondary findings in germline variants considered to be associated with hereditary tumors were detected in 9% (15\/160) of the patients. Seventeen patients (11%, 17\/160) were treated with genotype\u2010matched therapeutic agents, and the response rate was 47% (8\/17). The median turnaround time for physicians was 20\u00a0days, and the median survival time after the initial visit was 8.7\u00a0months. The results of the present study prove the feasibility of implementing in\u2010house clinical sequencing as a promising laboratory examination technique for precision cancer medicine.<\/jats:p>","DOI":"10.1111\/cas.14608","type":"journal-article","created":{"date-parts":[[2020,8,9]],"date-time":"2020-08-09T01:59:50Z","timestamp":1596938390000},"page":"3926-3937","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Clinical impact of a cancer genomic profiling test using an in\u2010house comprehensive targeted sequencing system"],"prefix":"10.1111","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4974-8015","authenticated-orcid":false,"given":"Hideyuki","family":"Hayashi","sequence":"first","affiliation":[{"name":"Division of Clinical Cancer Genomics Hokkaido University Hospital Sapporo Japan"},{"name":"Genomics Unit Keio Cancer Center Keio University School of Medicine Tokyo 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