As Therapeutic Modalities Expand, Genomic Profiling Must Keep Pace

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The boundaries of what’s considered “druggable” are shifting as advances in cell and gene therapies expand the possibilities for cancer treatment. For drug developers, this evolving therapeutic landscape creates new reasons to revisit challenging targets and explore genomic alterations that may have been overlooked when fewer treatment approaches were available.

A broader therapeutic toolbox opens new possibilities

For many decades, much of drug discovery was focused on finding a small molecule capable of binding a specific target. While this approach remains important, an expanded therapeutic toolkit now allows developers to target a wider range of biological mechanisms. The maturation of cell and gene therapies, RNA therapeutics, targeted protein degradation approaches, antibody-drug conjugates, and other modalities expand the range of biological targets that may be therapeutically tractable. In this way, disease mechanisms and targets that may once have been considered “undruggable” now warrant closer attention, as they can provide an opportunity for development teams to tackle more ambitious projects.

Improved genomic profiling means greater opportunity

Drug developers have often prioritized indications with a substantial unmet need and well-characterized driver genes supported by a strong biological rationale for therapeutic targeting. However, the landscape of cancer-associated variants is diverse and remains incompletely understood, even in well-studied forms of the disease. This creates a growing opportunity for researchers to identify and investigate a broader range of potentially relevant genomic alterations, both in indications already served by targeted therapies and in historically underexplored cancer types with substantial unmet need. One promising approach is to focus on a specific cohort with substantial unmet need while casting a wider net for variant discovery. Gaining broader genomic insights early in development can create more opportunities for discovery, biomarker development, and the identification of potentially transformative therapies.

Why genomic testing will remain essential

Many precision therapies rely on genomic information for patient selection, while drug discovery teams use genomic evidence to identify and prioritize targets for therapy development. Diseases such as cancer can be driven by both well-characterized and less common genetic alterations, making a comprehensive, reliable, and rapidly available view of an individual patient’s genomic landscape essential across the personalized medicine continuum, from target discovery through patient selection. While multiomics approaches provide important context for understanding disease biology, researchers must continue to examine genomic variation more broadly and in greater depth for personalized medicine to reach its full potential.

Closing the gap from sample to hypothesis

Realizing the potential of broader genomic insights to support therapy development across multiple emerging modalities presents several challenges. Translating samples into usable data at scale requires infrastructure that supports efficient, consistent processing across large cohorts and extended study timelines.

One component of closing this gap is comprehensive genomic profiling (CGP), which brings a wider range of cancer-associated genomic alterations into focus. By assessing single nucleotide variants, insertions and deletions, copy number variants, and select gene fusions, CGP allows researchers to look beyond familiar markers and investigate a broader genomic landscape. These expanded insights can open new avenues for biomarker research and therapeutic discovery.

Integrating sample stewardship, CGP, and analysis

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