$Clinical benefit of a precision medicine based approach for guiding treatment of refractory cancers$

Clinical benefit of a precision medicine based approach for guiding treatment of refractory cancers

Patients with metastatic solid tumors who had progressed on at least one line of standard of care therapy were referred to the Indiana University Health Precision Genomics Program. Tumor samples were submitted for DNA & RNA next-generation sequencing, fluorescence in situ hybridization, and immu...

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Bibliographic Details
Published in:	Oncotarget 2016-08, Vol.7 (35), p.56491-56500
Main Authors:	Radovich, Milan, Kiel, Patrick J, Nance, Stacy M, Niland, Erin E, Parsley, Megan E, Ferguson, Meagan E, Jiang, Guanglong, Ammakkanavar, Natraj R, Einhorn, Lawrence H, Cheng, Liang, Nassiri, Mehdi, Davidson, Darrell D, Rushing, Daniel A, Loehrer, Patrick J, Pili, Roberto, Hanna, Nasser, Callaghan, J Thomas, Skaar, Todd C, Helft, Paul R, Shahda, Safi, O'Neil, Bert H, Schneider, Bryan P
Format:	Article
Language:	eng
Subjects:	Aged Antineoplastic Combined Chemotherapy Protocols - therapeutic use Breast Neoplasms - genetics Breast Neoplasms - therapy Colorectal Neoplasms - genetics Colorectal Neoplasms - therapy Disease-Free Survival Female Genomics High-Throughput Nucleotide Sequencing Humans Immunohistochemistry In Situ Hybridization, Fluorescence Indiana Male Medical Oncology - methods Middle Aged Neoplasm Metastasis Neoplasms - genetics Neoplasms - therapy Pancreatic Neoplasms - genetics Pancreatic Neoplasms - therapy Precision Medicine - methods Research Design Research Paper Sarcoma - genetics Sarcoma - therapy Soft Tissue Neoplasms - genetics Soft Tissue Neoplasms - therapy Treatment Outcome Universities
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Summary:	Patients with metastatic solid tumors who had progressed on at least one line of standard of care therapy were referred to the Indiana University Health Precision Genomics Program. Tumor samples were submitted for DNA & RNA next-generation sequencing, fluorescence in situ hybridization, and immunohistochemistry for actionable targets. A multi-disciplinary tumor board reviewed all results. For each patient, the ratio of progression-free survival (PFS) of the genomically guided line of therapy divided by the PFS of their prior line was calculated. Patients whose PFS ratio was ≥ 1.3 were deemed to have a meaningful improvement in PFS. From April 2014-October 2015, 168 patients were evaluated and 101 patients achieved adequate clinical follow-up for analysis. 19 of 44 (43.2%) patients treated with genomically guided therapy attained a PFS ratio ≥ 1.3 vs. 3 of 57 (5.3%) treated with non-genomically guided therapy (p < 0.0001). Similarly, overall PFS ratios (irrespective of cutoff) were higher for patients with genomically guided therapy vs non-genomically guided therapy (p = 0.05). Further, patients treated with genomically guided therapy had a superior median PFS compared to those treated with non-genomically guided therapy (86 days vs. 49 days, p = 0.005, H.R. = 0.55, 95% C.I.:0.37-0.84). Patients with refractory metastatic cancer who receive genomically guided therapy have improved PFS ratios and longer median PFS compared to patients who do not receive genomically guided therapy.
ISSN:	1949-2553 1949-2553