Comprehensive tumor profiling-guided therapy in rare or refractory solid cancer: A feasibility study in daily clinical practice
Autor: | Marwan Ghosn, Elie El Rassy, Joseph Kattan, Fadi Farhat, Tony Ibrahim, Colette Hanna, Abir Ahmadie, Fadi El Karak |
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Rok vydání: | 2019 |
Předmět: |
0301 basic medicine
Oncology Male Cancer Research Kaplan-Meier Estimate Tumor response 0302 clinical medicine Neoplasms Antineoplastic Combined Chemotherapy Protocols Medicine Molecular Targeted Therapy In Situ Hybridization Aged 80 and over High-Throughput Nucleotide Sequencing Hematology General Medicine Middle Aged Immunohistochemistry Progression-Free Survival Neoplasm Proteins Clinical Practice Survival Rate 030220 oncology & carcinogenesis Female Algorithms Adult medicine.medical_specialty Solid cancer Clinical Decision-Making Protein Array Analysis Antineoplastic Agents 03 medical and health sciences Young Adult Rare Diseases Internal medicine Biomarkers Tumor Humans Radiology Nuclear Medicine and imaging In patient Objective response Response Evaluation Criteria in Solid Tumors Aged Probability business.industry Clinical trial Log-rank test 030104 developmental biology Mutation Feasibility Studies Personalized medicine business |
Zdroj: | Bulletin du cancer. 107(4) |
ISSN: | 1769-6917 |
Popis: | Tumor profiling has been shown to benefit patients with rare or refractory metastatic cancer, but several limitations hamper its use in daily clinical practice. We aim to assess the added benefit of a comprehensive tumor profiling, including factors predictive of response to targeted and cytotoxic therapy, in the treatment of refractory or rare solid tumors outside of a formal clinical trial. Patients were included between 2013 and 2017. Multiplatform comprehensive tumor profiling (CTP) was performed on FFPE specimens. Tumor response was evaluated by imaging using the RECIST criteria version 1.1. The PFS ratio was defined as PFS under CTP-guided therapy (PFS2)/PFS under previous standard therapy (PFS1). A clinical benefit was identified if the PFS ratio exceeded the 1.3 threshold value. In total, 184 patients were enrolled among whom 104 were evaluable for the PFS ratio. Objective response rates (ORR) were equal to 25% (CI95: 16.6-33.4%) and 36.5% (CI95: 27.2-45.8%) on the last therapy before CTP and on the CTP-guided therapy respectively (P-value=0.058 on paired proportion comparison test). The proportion of patients achieving a PFS2/PFS1 ratio≥1.3 was equal to 50%. The median PFS1 was statistically lower than PFS2 (120 days compared to 184 days respectively, P-value log rank 0.01). These results confirm the feasibility and the added benefit of a CTP in patients with refractory tumors in daily clinical practice especially in patients not able to enter a clinical trial. |
Databáze: | OpenAIRE |
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