Molecular profiling of advanced solid tumours. The impact of experimental molecular-matched therapies on cancer patient outcomes in early-phase trials: the MAST study

Introduction Molecular-matched therapies have revolutionized cancer treatment. We evaluated the improvement in clinical outcomes of applying an in-house customized Next Generation Sequencing panel in a single institution. Methods Patients with advanced solid tumors were molecularly selected to recei...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:British journal of cancer 2021-10, Vol.125 (9), p.1261-1269
Hauptverfasser: Gambardella, Valentina, Lombardi, Pasquale, Carbonell-Asins, Juan Antonio, Tarazona, Noelia, Cejalvo, Juan Miguel, González-Barrallo, Inés, Martín-Arana, Jorge, Tébar-Martínez, Roberto, Viala, Alba, Bruixola, Gema, Hernando, Cristina, Blasco, Inma, Papaccio, Federica, Martínez-Ciarpaglini, Carolina, Alfaro-Cervelló, Clara, Seda-García, Enrique, Blesa, Sebastián, Chirivella, Isabel, Castillo, Josefa, Montón-Bueno, José Vicente, Roselló, Susana, Huerta, Marisol, Pérez-Fidalgo, Alejandro, Martín-Martorell, Paloma, Insa-Mollá, Amelia, Fleitas, Tania, Rentero-Garrido, Pilar, Zúñiga-Trejos, Sheila, Cervantes, Andrés, Roda, Desamparados
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Introduction Molecular-matched therapies have revolutionized cancer treatment. We evaluated the improvement in clinical outcomes of applying an in-house customized Next Generation Sequencing panel in a single institution. Methods Patients with advanced solid tumors were molecularly selected to receive a molecular-matched treatment into early phase clinical trials versus best investigators choice, according to the evaluation of a multidisciplinary molecular tumor board. The primary endpoint was progression-free survival (PFS) assessed by the ratio of patients presenting 1.3-fold longer PFS on matched therapy (PFS2) than with prior therapy (PFS1). Results Of a total of 231 molecularly screened patients, 87 were eligible for analysis. Patients who received matched therapy had a higher median PFS2 (6.47 months; 95% CI, 2.24–14.43) compared to those who received standard therapy (2.76 months; 95% CI, 2.14–3.91, Log-rank p = 0.022). The proportion of patients with a PFS2/PFS1 ratio over 1.3 was significantly higher in the experimental arm (0.33 vs 0.08; p = 0.008). Discussion We demonstrate the pivotal role of the institutional molecular tumor board in evaluating the results of a customized NGS panel. This process optimizes the selection of available therapies, improving disease control. Prospective randomized trials are needed to confirm this approach and open the door to expanded drug access.
ISSN:0007-0920
1532-1827
DOI:10.1038/s41416-021-01502-x