Abstract 5702
Background
In recent years, molecular interrogation of tumors and deployment of matched individualized precision therapies has shown remarkable responses in a variety of refractory malignancies. However, to date, few prospective studies have evaluated comprehensive next-generation sequencing (NGS) testing for actionable genomic alterations to guide matched therapy in advanced refractory solid tumors with extensively poor performance status.
Methods
The study was a prospective, observational mono-institutional study. The main eligibility criteria were that patients diagnosed with treatment-refractory disease with poor performance status (ECOG PS ≥ 3) undergoing commercial NGS (Foundation Medicine) testing with the intent of clinical application of available matched targeted agents. Variants were classified in three levels of actionability using a novel scale tool. Treatment recommendations were discussed in a molecular tumor board. Among these treated patients, the primary end point for the analysis was the ORR. Secondary end points included DCR, PFS, OS and safety. The registry is ongoing.
Results
From October 2018 to April 2019, 48 patients were enrolled, which concluded ovarian cancer, stomach cancer, liver cancer, and so on, all underwent NGS of a metastatic site biopsy. About 93.8 percent of patients underwent successful molecular analysis (93.8%) and treatment recommendations were given to 28 patients (62.2 %). These included single-agent targeted therapies (60.7%), checkpoint inhibitors (25%), and combination targeted therapies (14.3%). Treatment recommendations were implemented in 22 of 28 patients (78.6%), of whom 8 (36.4%) showed complete remission (n = 1) or partial response (n = 7), in addition, 16 patients (72.7%) receiving off-label treatments.
Conclusions
Genomic-guided individualized precision therapy is effective for a small proportion of patients in challenging clinical situations. Molecular tumor board and evidenced based actionable gene variation scale tool are effective approach to improve the effectiveness of genomic-guided precision therapy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Institutional review board of the Second Hospital of Tianjin Medical University.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.
Resources from the same session
5705 - External validation and longitudinal extension of the LIPI (Lung Immune Prognostic Index) for immunotherapy outcomes in advanced non-small cell lung cancer.
Presenter: Jakob Riedl
Session: Poster Display session 3
Resources:
Abstract
5758 - Changes of TCR Repertoire in Metastatic Renal Cell Carcinoma and Metastatic Melanoma Patients Treated with Nivolumab
Presenter: Martin Klabusay
Session: Poster Display session 3
Resources:
Abstract
1743 - Expression of MHC class I, HLA-A and HLA-B identifies immune activated breast tumors with favorable outcome
Presenter: María Del Mar Noblejas López
Session: Poster Display session 3
Resources:
Abstract
2219 - Prognostic Significance of Tumor Tissue NeuGcGM3 Ganglioside Expression and Predictive Value of Circulating Tumor Cell Count Monitoring in Patients Receiving Racotumomab Immunotherapy
Presenter: Necdet Üskent
Session: Poster Display session 3
Resources:
Abstract
2996 - Evolution of Myeloid-Derived Suppressor Cells and Objective Response Rate in Relapsed/Refractory Diffuse Large B Cell Lymphoma (R/R DLBCL) patients after receiving immunotherapy
Presenter: Carlos Jiménez Cortegana
Session: Poster Display session 3
Resources:
Abstract
2110 - A Phase Ia/Ib trial of the anti-programmed death-ligand 1 (PD-L1) human monoclonal antibody (mAb), CS1001, in patients (pts) with advanced solid tumors or lymphomas
Presenter: Lin Shen
Session: Poster Display session 3
Resources:
Abstract
3515 - Results from a randomised Phase 1/2 trial evaluating the safety and antitumour activity of anti-PD-1 (MEDI0680)/anti-PD-L1 (durvalumab) vs anti-PD-1 (nivolumab) alone in metastatic clear cell renal cell carcinoma (ccRCC)
Presenter: Martin Voss
Session: Poster Display session 3
Resources:
Abstract
3566 - Pembrolizumab in Advanced Rare Cancers
Presenter: Aung Naing
Session: Poster Display session 3
Resources:
Abstract
3567 - High clinical benefit rates of pembrolizumab in very rare sarcoma histotypes: first results of the AcSé Pembrolizumab study
Presenter: Jean-Yves Blay
Session: Poster Display session 3
Resources:
Abstract
2421 - Lenvatinib plus PD-1 blockade in advanced bile tract carcinoma.
Presenter: Jianzhen Lin
Session: Poster Display session 3
Resources:
Abstract