Overall survival in patients with pancreatic cancer receiving matched therapies following molecular profiling: a retrospective analysis of the Know Your Tumor registry trial
| Autor: | Vaibhav Sahai, Vincent Chung, Patricia DeArbeloa, Sam Mikhail, Michael J. Pishvaian, Andrew Eugene Hendifar, Dzung Thach, Jonathan R. Brody, Edik M. Blais, Emanuel F. Petricoin, Subha Madhavan, Davendra Sohal, Emily Lyons, Lola Rahib, Lynn M. Matrisian, Sara Bellakbira |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Oncology Adult Male medicine.medical_specialty Oncology and Carcinogenesis 03 medical and health sciences Pancreatic Cancer 0302 clinical medicine Rare Diseases Clinical Research Internal medicine Pancreatic cancer Overall survival Retrospective analysis 80 and over Medicine Humans In patient Oncology & Carcinogenesis Molecular Targeted Therapy Registries Cancer Aged Retrospective Studies Aged 80 and over business.industry Hazard ratio Middle Aged Precision medicine medicine.disease Tumor registry United States Clinical trial Pancreatic Neoplasms Survival Rate 030104 developmental biology Good Health and Well Being 030220 oncology & carcinogenesis Female business Digestive Diseases |
| Zdroj: | The Lancet. Oncology, vol 21, iss 4 |
| ISSN: | 1474-5488 |
| Popis: | BackgroundAbout 25% of pancreatic cancers harbour actionable molecular alterations, defined as molecular alterations for which there is clinical or strong preclinical evidence of a predictive benefit from a specific therapy. The Know Your Tumor (KYT) programme includes US patients with pancreatic cancer and enables patients to undergo commercially available multi-omic profiling to provide molecularly tailored therapy options and clinical trial recommendations. We sought to determine whether patients with pancreatic cancer whose tumours harboured such actionable molecular alterations and who received molecularly matched therapy had a longer median overall survival than similar patients who did not receive molecularly matched therapy.MethodsIn this retrospective analysis, treatment history and longitudinal survival outcomes were analysed in patients aged 18 years or older with biopsy-confirmed pancreatic cancer of any stage, enrolled in the KYT programme and who received molecular testing results. Since the timing of KYT enrolment varied for each patient, the primary outcome measurement of median overall survival was calculated from the initial diagnosis of advanced disease until death. We compared median overall survival in patients with actionable mutations who were treated with a matched therapy versus those who were not treated with a matched therapy.FindingsOf 1856 patients with pancreatic cancer who were referred to the KYT programme between June 16, 2014, and March 31, 2019, 1082 (58%) patients received personalised reports based on their molecular testing results. Actionable molecular alterations were identified in 282 (26%) of 1082 samples. Among 677 patients for whom outcomes were available, 189 had actionable molecular alterations. With a median follow-up of 383 days (IQR 214-588), those patients with actionable molecular alterations who received a matched therapy (n=46) had significantly longer median overall survival than did those patients who only received unmatched therapies (n=143; 2·58 years [95% CI 2·39 to not reached] vs 1·51 years [1·33-1·87]; hazard ratio 0·42 [95% CI 0·26-0·68], p=0·0004). The 46 patients who received a matched therapy also had significantly longer overall survival than the 488 patients who did not have an actionable molecular alteration (2·58 years [95% CI 2·39 to not reached] vs 1·32 years [1·25-1·47]; HR 0·34 [95% CI 0·22-0·53], p |
| Databáze: | OpenAIRE |
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