JOURNAL of
ONCOLOGICAL
SCIENCES

ORIGINAL RESEARCH ARTICLE

The Impact of Hybrid Capture-Based Comprehensive Genomic Profiling on Treatment Strategies in Patients with Solid Tumors
Received Date : 01 Mar 2022
Accepted Date : 13 Jun 2022
Available Online : 01 Jul 2022
Doi: 10.37047/jos.2022-89310 - Article's Language: EN
J Oncol Sci. 2022;8(2):87-93
This is an open access article under the CC BY-NC-ND license
ABSTRACT
The development of bioinformatics and comprehensive genomic profiling (CGP) has provided insights into the applicability and functionality of the genomic alterations (GA). In this study, we evaluated the impact of CGP on the treatment plan and outcomes in a significant number of patients. Material and Methods: We carried out a retrospective case-control study on 164 adult patients with advanced solid tumors from 15 oncology centers in Türkiye. Results: In all cases, CGP was performed within 23.8 [standard deviation (SD)±32.1] months of initial diagnosis. Non-small cell lung carcinoma, breast cancer, unknown primary carcinoma, colorectal carcinoma, and sarcoma were among the most common tumor types, accounting for 61.5% of all cases. CGP was performed immediately after the diagnosis of advanced cancer in 13 patients (7.9%). In 158 patients (96.4%), at least one GA was found as per the CGP report. Also, in the reports, the average tumor mutational burden (TMB) and GAs were 7.3 (SD±8.7) mut/Mb and 3.5 (SD±2.0), respectively. According to CGP reports, 58 patients had 79 evidence-based drug suggestions for their particular tumor type, whereas 97 patients had 153 evidence-based drug suggestions for another tumor type. After the primary oncologist interpreted the CGP reports, significant changes were made to the treatment of 35 (21.3%) patients. Conclusion: We strongly believe that in the future, high-TMB or other tumor-agnostic biomarkers will become much more affordable, and CGP will serve as one of the major decision-making tools for the treatment of patients along with pathological, radiological or laboratory tests.
REFERENCES
  1. Johnson TM. Perspective on precision medicine in oncology. Pharmacotherapy. 2017;37(9):988-989. [Crossref]  [PubMed]  [PMC] 
  2. Cheng DT, Mitchell TN, Zehir A, et al. Memorial sloan kettering-integrated mutation profiling of actionable cancer targets (MSK-IMPACT): a hybridization capture-based next-generation sequencing clinical assay for solid tumor molecular oncology. J Mol Diagn. 2015;17(3):251-264. [Crossref]  [PubMed]  [PMC] 
  3. Schwaederle M, Zhao M, Lee JJ, et al. Impact of precision medicine in diverse cancers: a meta-analysis of phase II clinical trials. J Clin Oncol. 2015;33(32):3817-3825. [Crossref]  [PubMed]  [PMC] 
  4. De Falco V, Poliero L, Vitello PP, et al. Feasibility of next-generation sequencing in clinical practice: results of a pilot study in the Department of Precision Medicine at the University of Campania 'Luigi Vanvitelli'. ESMO Open. 2020;5(2):e000675. Erratum in: ESMO Open. 2020;5(3). [Crossref]  [PubMed]  [PMC] 
  5. Looney AM, Nawaz K, Webster RM. Tumour-agnostic therapies. Nat Rev Drug Discov. 2020;19(6):383-384. [Crossref]  [PubMed] 
  6. Singh AP, Shum E, Rajdev L, et al. Impact and diagnostic gaps of comprehensive genomic profiling in real-world clinical practice. Cancers (Basel). 2020;12(5):1156. [Crossref]  [PubMed]  [PMC] 
  7. Tsimberidou AM, Hong DS, Ye Y, et al. Initiative for molecular profiling and advanced cancer therapy (IMPACT): an MD anderson precision medicine study. JCO Precis Oncol. 2017;2017:PO.17.00002. [PubMed]  [PMC] 
  8. Wheler JJ, Janku F, Naing A, et al. Cancer therapy directed by comprehensive genomic profiling: a single center study. Cancer Res. 2016;76(13):3690-3701. [Crossref]  [PubMed] 
  9. Frampton GM, Fichtenholtz A, Otto GA, et al. Development and validation of a clinical cancer genomic profiling test based on massively parallel DNA sequencing. Nat Biotechnol. 2013;31(11):1023-1031. [Crossref]  [PubMed]  [PMC] 
  10. Sailer V, Eng KW, Zhang T, et al. Integrative molecular analysis of patients with advanced and metastatic cancer. JCO Precis Oncol. 2019;3:PO.19.00047. [PubMed]  [PMC] 
  11. Fumagalli C, Catania C, Ranghiero A, et al. Molecular profile of advanced non-small cell lung cancers in octogenarians: the door to precision medicine in elderly patients. J Clin Med. 2019;8(1):112. [Crossref]  [PubMed]  [PMC] 
  12. Mosele F, Remon J, Mateo J, et al. Recommendations for the use of next-generation sequencing (NGS) for patients with metastatic cancers: a report from the ESMO Precision Medicine Working Group. Ann Oncol. 2020;31(11):1491-1505. [Crossref]  [PubMed] 
  13. Drilon A, Wang L, Arcila ME, et al. Broad, hybrid capture-based next-generation sequencing identifies actionable genomic alterations in lung adenocarcinomas otherwise negative for such alterations by other genomic testing approaches. Clin Cancer Res. 2015;21(16):3631-3639. [Crossref]  [PubMed]  [PMC] 
  14. Massard C, Michiels S, Ferté C, et al. High-throughput genomics and clinical outcome in hard-to-treat advanced cancers: results of the MOSCATO 01 Trial. Cancer Discov. 2017;7(6):586-595. [Crossref]  [PubMed] 
  15. Marabelle A, Fakih MG, Lopez J, et al. Association of tumour mutational burden with outcomes in patients with select advanced solid tumours treated with pembrolizumab in KEYNOTE-158. Ann Oncol. 2019;30(5):477-478. [Crossref] 
  16. Chang H, Sasson A, Srinivasan S, et al. Bioinformatic methods and bridging of assay results for reliable tumor mutational burden assessment in non-small-cell lung cancer. Mol Diagn Ther. 2019;23(4):507-520. [Crossref]  [PubMed]  [PMC] 
  17. Zimmer K, Kocher F, Spizzo G, Salem M, Gastl G, Seeber A. Treatment according to molecular profiling in relapsed/refractory cancer patients: a review focusing on latest profiling studies. Comput Struct Biotechnol J. Mar 2019;17:447-453. [Crossref]  [PubMed]  [PMC]