Results from a study of 1,944 patients with advanced cancer in France indicates widespread standard genomic testing is feasible for this group of patients.
This analysis, which was presented at the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting, entailed using next-generation sequencing and whole-genome-comparative genomic hybridization to construct genomic profiles of tumors to help guide treatment decisions. Both technologies are widely available in France and elsewhere in the world, according to the authors.
The samples came from a variety of tumors including those of colorectal, gynecologic, breast, brain, headand neck cancer, and sarcoma patients. The technology analyzed 69 cancer-related genes.
An estimated 52 percent of these tumor samples contained actionable mutations, with 609 patients possessing one actionable mutation and 394 possessing two or more. The most common actionable mutation was the PI3K/mTOR pathway.
A multidisciplinary board of experts convened on a weekly basis to go over these genomic testing results and provide recommendations for the best targeted therapies.
“We recommended molecularly targeted therapies to patients who had mutations in pathways that could be targeted with either commercially available drugs or those tested in early clinical trials,” said lead study author Olivier Tredan, M.D., Ph.D., the chair of the Department of Medical Oncology at the Centre Léon Bérard in Lyon, France, in a statement.
Molecularly targeted treatments were recommended to 676 patients or 35 percent of the 1,944 tested according to availability of drugs hitting either the specific target protein or pathway activated by the target.
Of those 143 patients received the recommended treatments, mostly through clinical trial enrollment, while another 533 patients were ineligible to receive these drugs due to factors like poor health/rapid progression of cancer or not meeting the eligibility criterion for the clinical trials.
Ultimately, the scientists compared survival rates between the 143 patients who got these therapies against the 502 who did not.
About 53.7 percent of patients who got the recommended therapy targeted therapy were alive at three years versus 46.1 percent of patients who did not.
“This study confirms that comprehensive genomic profiling can be performed in routine practice to select patients for targeted cancer therapies,” continued Tredan. The technology is widely available and requires only a small amount of DNA. Theoretically, we could do this testing for every patient in France.”
The trial is still ongoing, but the team is planning a new phase of it the investigation where they will gage the 70-gene test used in this study to a commercial 315-gene test. The hope is that this would help ascertain if screening a large number of genes can lead to more targeted therapy recommendations.
Filed Under: Genomics/Proteomics