1. Real-world data from a molecular tumor board demonstrates improved outcomes with a precision N-of-One strategy.
- Author
-
Kato, Shumei, Kim, Ki Hwan, Lim, Hyo Jeong, Boichard, Amelie, Nikanjam, Mina, Weihe, Elizabeth, Kuo, Dennis J, Eskander, Ramez N, Goodman, Aaron, Galanina, Natalie, Fanta, Paul T, Schwab, Richard B, Shatsky, Rebecca, Plaxe, Steven C, Sharabi, Andrew, Stites, Edward, Adashek, Jacob J, Okamura, Ryosuke, Lee, Suzanna, Lippman, Scott M, Sicklick, Jason K, and Kurzrock, Razelle
- Subjects
Humans ,Neoplasms ,Antineoplastic Agents ,Disease-Free Survival ,Treatment Outcome ,Genome ,Human ,Adolescent ,Adult ,Aged ,Aged ,80 and over ,Middle Aged ,Child ,Child ,Preschool ,Female ,Male ,Young Adult ,Precision Medicine ,Circulating Tumor DNA ,Genome ,Human ,and over ,Preschool - Abstract
Next-generation sequencing (NGS) can identify novel cancer targets. However, interpreting the molecular findings and accessing drugs/clinical trials is challenging. Furthermore, many tumors show resistance to monotherapies. To implement a precision strategy, we initiated a multidisciplinary (basic/translational/clinical investigators, bioinformaticians, geneticists, and physicians from multiple specialties) molecular tumor board (MTB), which included a project manager to facilitate obtaining clinical-grade biomarkers (blood/tissue NGS, specific immunohistochemistry/RNA expression including for immune-biomarkers, per physician discretion) and medication-acquisition specialists/clinical trial coordinators/navigators to assist with medication access. The MTB comprehensively reviewed patient characteristics to develop N-of-One treatments implemented by the treating physician's direction under the auspices of a master protocol. Overall, 265/429 therapy-evaluable patients (62%) were matched to ≥1 recommended drug. Eighty-six patients (20%) matched to all drugs recommended by MTB, including combinatorial approaches, while 38% received physician's choice regimen, generally with unmatched approach/low degree of matching. Our results show that patients who receive MTB-recommended regimens (versus physician choice) have significantly longer progression-free (PFS) and overall survival (OS), and are better matched to therapy. High (≥50%) versus low (
- Published
- 2020