| Autor: |
C. Pixberg, M. Zapatka, M. Hlevnjak, S. Benedetto, J.P. Suppelna, J. Heil, K. Smetanay, L. Michel, C. Fremd, V. Körber, M. Rübsam, L. Buschhorn, S. Heublein, B. Schäfgen, M. Golatta, C. Gomez, A. von Au, M. Wallwiener, S. Wolf, N. Dikow, C. Schaaf, E. Gutjahr, M. Allgäuer, A. Stenzinger, K. Pfütze, R. Kirsten, D. Hübschmann, H.-P. Sinn, D. Jäger, A. Trumpp, R. Schlenk, T. Höfer, V. Thewes, A. Schneeweiss, P. Lichter |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
ESMO open. 7(6) |
| ISSN: |
2059-7029 |
| Popis: |
COGNITION (Comprehensive assessment of clinical features, genomics and further molecular markers to identify patients with early breast cancer for enrolment on marker driven trials) is a diagnostic registry trial that employs genomic and transcriptomic profiling to identify biomarkers in patients with early breast cancer with a high risk for relapse after standard neoadjuvant chemotherapy (NACT) to guide genomics-driven targeted post-neoadjuvant therapy.At National Center for Tumor Diseases Heidelberg patients were biopsied before starting NACT, and for patients with residual tumors after NACT additional biopsy material was collected. Whole-genome/exome and transcriptome sequencing were applied on tumor and corresponding blood samples.In the pilot phase 255 patients were enrolled, among which 213 were assessable: thereof 48.8% were identified to be at a high risk for relapse following NACT; 86.4% of 81 patients discussed in the molecular tumor board were eligible for a targeted therapy within the interventional multiarm phase II trial COGNITION-GUIDE (Genomics-guided targeted post neoadjuvant therapy in patients with early breast cancer) starting enrolment in Q4/2022. An in-depth longitudinal analysis at baseline and in residual tumor tissue of 16 patients revealed some cases with clonal evolution but largely stable genetic alterations, suggesting restricted selective pressure of broad-acting cytotoxic neoadjuvant chemotherapies.While most precision oncology initiatives focus on metastatic disease, the presented concept offers the opportunity to empower novel therapy options for patients with high-risk early breast cancer in the post-neoadjuvant setting within a biomarker-driven trial and provides the basis to test the value of precision oncology in a curative setting with the overarching goal to increase cure rates. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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