|
|
|
|
|
|
|
|
abstract
Highlights
- •
- Few effective standard options available for patients with refractory disease
- •
- Identification of genomic alterations can inform treatment decisions.
- •
- Point-of-care management using this approach is feasible.
- •
- A molecular tumor board (MTB) is an important component of point-of-care management.
- •
- Implementation barriers of MTB-based therapeutic recommendations are discussed.
Abstract
Objective
To
determine the feasibility and clinical utility of using comprehensive
genomic profiling (CGP) in the course of clinical care to identify
clinically relevant tumor genomic alterations for patients with either
rare or refractory gynecologic cancers to facilitate point-of-care
management. Use of an expert, multidisciplinary, institutional molecular
tumor board (MTB) assessment is discussed regarding input on putative
targeted options for individualized therapy.
Methods
A
prospective clinical trial is ongoing. We report on the initial 69
patients with gynecologic cancers that were either rare or refractory to
standard therapy. CGP was performed by Foundation Medicine, Inc.
Genomic alterations were reviewed by members of an MTB. Consensus
recommendations on genomically targeted, FDA-approved, on- and off-label
therapies and clinical trials were sent to the treating physician, and
decisions and outcomes were assessed.
Results
Study
outcomes were available for 64 patients. The mean number of genes
altered per tumor was 4.97 (median = 4; range, 1–26), and the average
turnaround time from testing laboratory report to generation of formal
recommendations was approximately three weeks. Evaluation of genomic and
clinical data by the MTB led to generation of targeted treatment
options in all 64 patients, and the percentage of patients for whom one
or more of these recommendations were implemented by the treating
physician was 39%. Sixty-four percent of the patients receiving targeted
therapy based on a CGP result experienced radiologic response or showed
evidence of clinical benefit or stable disease.
Conclusion
These
data suggest that an institutional MTB is a feasible venue for
reviewing tumor genomic profiling results and generating clinical
recommendations. These data also support the need for further studies
and guidelines on clinical decision making with greater availability of
broad genomically based diagnostics.
0 comments :
Post a Comment
Your comments?
Note: Only a member of this blog may post a comment.