424P - MD Anderson Cancer Center global precision oncology decision support (Glo-PODS) clinical trial genomic support: Pilot program at the Prince of Wales Hospital (Chinese University of Hong Kong - CUHK)

Background

The MD Anderson Precision Oncology Decision Support (PODS) group provides genomic support to clinicians to guide enrollment onto genotype-matched trials through gene annotation and reporting on therapeutic actionability of genomic alterations based on NGS reports. PODS was evaluated in a pilot study (Glo-PODS) at a CUHK-affiliated hospital in Hong Kong.

Methods

Patients with predominantly GI solid tumors who participated in two prospective precision oncology studies (PROCURE, STARTRK) at the CUHK were enrolled. Eligible patients had commercially available NGS panel analysis of their respective tumors. Genomic alterations of their NGS reports were annotated by the PODS to determine therapeutic actionability based on the variant’s known or potential functional and/or therapeutic significance. Data collected: demographics, treatment outcomes and impact on clinical decision and trial enrollment.

Results

A total of 144 Chinese patients were enrolled from Feb 2020-2023 - primary diagnosis of colorectal 79.2%, gastric/gastroesophageal 4.9%, pancreatic 4.2%, lung 2.1%, endometrial 0.7%, cervical 0.7% & unknown primary 0.7%. NGS reports were derived from 3 different NGS panels. Of the 131 patients data analyzed to date, 1,367 annotations were performed on 902 unique genomic alterations plus TMB and MSI status. Of the 1367 annotations, 395 (28.9%) were actionable, 317 (23.2%) were potentially actionable, 478 (35%) had unknown actionability, 177 (12.9%) were not actionable. PODS reports matched 41/144 (28.5%) patients to clinical trials at CUHK. Most common reason for low matching trial enrollment was lack of availability of suitable trials. Based on molecular tumor board decisions, PODS report contributed to clinical decisions in 15 patients.

Conclusions

Over 50% of genomic alteration annotations were deemed actionable/ potentially actionable by PODS in this cohort of Asian patients with predominantly GI cancers. PODS influenced clinical management in ∼10% of patients, but not trial enrollment. Compared with US experience, our results should be interpreted in the context of differences in cancer-type & clinical trial landscape.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The Chinese University of Hong Kong Sheikh Khalifa Bin Zayed Al Nahyan Institute for Personalized Cancer Therapy. MD Anderson Cancer Center.

Funding

Sister Institution Network Fund Grant 2022-00060827-Y1.

Disclosure

B.B.Y. Ma: Financial Interests, Personal, Invited Speaker, Advisory Board/Consultancy: Novartis, BMS, MSD; Financial Interests, Personal, Advisory Board, Consultancy: Y-biologics, Boehringer Ingelheim, Merck Serono; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Advisory Board, Ad board and consultancy: Viracta Therapeutics; Financial Interests, Personal, Other, Consultancy: Alentis; Financial Interests, Institutional, Research Grant, Preclinical Research Grant: Novartis; Financial Interests, Institutional, Research Grant: Boehringer Ingelheim, Merck Serono; Financial Interests, Institutional, Research Grant, Research Grant Preclinical: Novartis; Non-Financial Interests, Personal, Principal Investigator, NRG oncology study PI: NRG oncology. H.H.F. Loong: Financial Interests, Institutional, Invited Speaker: Boehringer Ingelheim, MSD; Financial Interests, Personal, Invited Speaker: Eli Lilly, Illumina, Bayer, Guardant Health; Financial Interests, Personal, Advisory Board: Novartis, Takeda. R.N. Lui: Financial Interests, Personal, Advisory Board, Advisor at the Gilead Asia Hepatitis Medical Affairs Advisory Program 2020: Gilead Sciences, Inc; Financial Interests, Personal, Invited Speaker, Delivered CME talks on stool bacterial DNA markers as a modality for colorectal cancer screening; updates on the role of the microbiota in colorectal cancer: GenieBiome Ltd; Financial Interests, Personal, Stocks/Shares: Pfizer Inc; Non-Financial Interests, Personal, Leadership Role, Honorary Treasurer--> Honorary Secretary from 2022 onwards: The Hong Kong Association for the Study of Liver DIseases Limited; Non-Financial Interests, Personal, Member of Board of Directors, Social Media Editor: Journal of Gastroenterology and Hepatology; Non-Financial Interests, Personal, Advisory Role, Editor and Member of Expert Advisory Panel on Social Media: Hong Kong Medical Journal; Non-Financial Interests, Personal, Leadership Role, Co-Chair, Emerging Leaders Committee: Asian Pacific Association of Gastroenterology; Non-Financial Interests, Personal, Member, Trainee & Early Career Advisory Group 2021-2022: American Society of Clinical Oncology. J. Rodon: Financial Interests, Personal, Advisory Board: Ellipses Pharma, IONCTURA SA, Aadi Bioscience, Envision Pharma; Financial Interests, Personal, Other, Consultancy: Clarion Healthcare, Debiopharm, Cullgen, Pfizer, Macrogenics, Oncology One, Columbus Venture Partners, Sardona Therapeutics, Avoro Capital Advisors, Vall d'Hebron Institute of Oncology/Ministero De Empleo Y Seguridad, Chinese University of Hong Kong, Boxer Capital, LLC, Tang Advisors, LLC, Alnylam Pharmaceuticals; Financial Interests, Personal, Other, Consultancy/Advisory Board: Monte Rosa Therapeutics, Merus N.V., Incyte; Financial Interests, Institutional, Other, Clinical Research: Spectrum Pharmaceuticals, Novartis, Symphogen, BioAtla, Pfizer, GenMab, CytomX, Kelun-Biotech, Takeda-Millenium, GSK; Financial Interests, Institutional, Other, Research Funding: Blueprint Medicines, Black Diamond, Merck Sharp & Dohme; Financial Interests, Institutional, Research Grant, Research Funding/Clinical Research: Hummingbird, Yingli; Financial Interests, Institutional, Research Grant, Research Funding: Vall d'Hebron Institute of Oncology/Cancer Core Europe; Financial Interests, Institutional, Research Grant, Clinical Research: AadiBioscience, Bicycle Therapeutics, Taiho, Roche Pharmaceuticals, Merus, Curis, Nuvation, ForeBio, Deciphera, Ideaya, Amgen, Hutchinson MediPharma, BioMed Valley Discoveries, Loxo Oncology, Cellestia, Tango Therapeutics, Mirati, Linnaeus Therapeutics, Bayer; Other, Personal, Other, Other: VHIO/Ministero De Empleo Y Seguridad Social; Other, Personal, Other, Travel: European Society for Medical Oncology, Loxo Oncology. F. Meric-Bernstam: Financial Interests, Personal, Other, Consultant: AstraZeneca, F. Hoffman-La Roche Ltd., Zymeworks, OnCusp Therapeutics; Financial Interests, Personal, Advisory Board, Advisory Board/Consultant: Seagen; Financial Interests, Personal, Advisory Board: Zentalis, Karyopharm, Biovica, Eisai, Protai, TheraTechnologies; Financial Interests, Personal, Other, Consulting: Tallac Therapeutics, Lengo Therapeutics, LOXO-Oncology, Black Diamond, Infinity Pharmaceuticals, AbbVie, GT Aperion, Ecor1; Financial Interests, Personal, Other, Consutling: Menarini Group; Financial Interests, Institutional, Other, Local PI / Research Grant: Aileron Therapeutics, Bayer Healthcare, CytomX Therapeutics Inc., Daiichi Sankyo Co. Ltd., eFFECTOR Therapeutics, Taiho Pharmaceutical Co.; Financial Interests, Institutional, Other, Local PI / Research Grant / Coordinating PI: AstraZeneca; Financial Interests, Institutional, Local PI: Calithera Biosciences, Curis Inc., Debiopharm International, Guardant Health Inc., Klus Pharma, Novartis; Financial Interests, Institutional, Other, Local PI / Steering Committee Member: Genentech Inc.; Financial Interests, Institutional, Research Grant: Takeda Pharmaceutical Co., Puma Biotechnology Inc., Repare; Other, Personal, Other, Travel Support: Cholangiocarcinoma Foundation; Other, Personal, Other, Travel support: European Organisation for Research and Treatment of Cancer (EORTC), European Society for Medical Oncology (ESMO). T.A. Yap: Financial Interests, Personal, Other, Consultant: Almac, Aduro, AstraZeneca, Atrin, Axiom, Bayer, Bristol Myers Squibb, Clovis, Cybrexa, EMD Serono, Guidepoint, Ignyta, I-Mab, Jansen, Merck, Pfizer, Repare, Roche, Schrodinger, Varian, Zai Labs, AbbVie, Acrivon, Adagene, Amphista, Artios, Athena, Avoro, Baptist Health Systems, BeiGene, Boxer, C4 Therapeutics, Calithera, Cancer Research UK, F-Star, Genmab, Glenmark, GLG, Globe Life Sciences, GSK, Institut Gustave Roussy, Diffusion, Idience, ImmuneSensor, Intellisphere, Kyn, MEI Pharma, Mereo, Natera, Nexys, Novocure, OHSU, OncoSec, Ono Pharma, Pegascy, PER, Piper-Sandler, Prolynx, resTORbio, Theragnostics, ZielBio, Versant, Vibliome, Xinthera, Radiopharm Theranostics, Sanofi, CUHK Committee, Pliant Therapeutics, Ellipses.Life, LRG1, Panangium, Seagen, Synthis, Tessellate Bio, TD2 Theragonostics, Tome Biosciences, Zentalis; Financial Interests, Personal, Other, University of Texas MD Anderson Cancer Center, where I am Medical Director of the Institute for Applied Cancer Science, which has a commercial interest in DDR and other inhibitors (IACS30380/ART0380 was licensed to Artios): MD Anderson Cancer Center, Institute for Applied Cancer Sciences; Financial Interests, Personal, Stocks/Shares: Seagan; Financial Interests, Institutional, Other, Grant/Research support: Bayer, Cyteir, EMD Serono, GSK, Karyopharm, Pfizer, Repare, Sanofi, Artios, AstraZeneca, BeiGene, BioNTech, Blueprint, BMS, Clovis, Constellation, Eli Lilly, Forbius, F-Star, Haihe, ImmuneSensor, Ionis, Ipsen, Jounce, Ribon Therapeutics, Genentech, Novartis, KSQ, Kyowa, Merck, Mirati, Regeneron, Tesaro, Rubius, Scholar Rock, Seattle Genetics, Vivace, Acrivon, Zenith; Financial Interests, Institutional, Research Grant: Ideaya, Boundless Bio; Financial Interests, Institutional, Other, Grant/Research Support: Acrivon. All other authors have declared no conflicts of interest.