Abstract 1834P
Background
Comprehensive genomic profiling (CGP) improved clinical outcome in patients with advanced tumors in numerous studies. An interdisciplinary team approach is crucial to identify new therapeutic options based on CGP results. The Comprehensive Cancer Center Zurich (C3Z) established a Molecular Tumor Board (MTB) with this intent. We assessed the impact of personalized approaches on clinical outcomes of patients discussed at the MTB.
Methods
The MTB is held by experienced senior physicians and researchers. Main discussion points are clinical and molecular characteristics, actionability of alterations and availability of targeted agents and clinical trials. Included patients had advanced stage cancer and received CGP (FoundationOneCDx®, Oncomine Focus or Comprehensive Assay™) with discussion at the MTB between 2018 - 2020. In patients, in whom the recommended therapy was implemented and who had had a therapy line prior to MTB, the PFS2 (PFS of recommended therapy) to PFS1 (PFS of prior line) ratio was calculated.
Results
Of 506 included patients, 55% were male and median age was 64 years (range 20-90). Patients received a median of 1 prior therapy line. Tumor entities were lung (40%), colorectal (11%), biliary tract (7%), sarcomas (6%), urogenital (6%), head and neck (6%), pancreas (5%), breast (4%), gynecological (4%), and others (11%). A new therapy or trial option based on CGP was recommended in n=208 (41%) patients (therapy n=137 [27%]; trial n=44 [9%]; both n=27 [5%]). Of the n=164 (32%) receiving a therapy suggestion, this therapy was implemented in n=73 (45%), of whom n=56 qualified for PFS2/PFS1 calculation. A PFS2/PFS1 ratio of ≥1.3 was observed in at least n=18 (32%) patients.
Conclusions
Molecular testing and discussion at the MTB permitted recommendation of a new systemic therapy option in roughly one third of included patients. We recommend to perform CGP and discussion at an MTB in advanced or rare solid tumors, at the latest after standard of care therapy. Moreover, clearly defined molecular testing algorithms in the different tumor subtypes should be implemented.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
A. Curioni-Fontecedro: Financial Interests, Advisory Board: Amgen; Financial Interests, Advisory Board: AstraZeneca; Financial Interests, Advisory Board: Boehringer Ingelheim; Financial Interests, Advisory Board: Bristol Meyer Squibb; Financial Interests, Advisory Board: MSD; Financial Interests, Advisory Board: Novartis; Financial Interests, Advisory Board: Roche; Financial Interests, Advisory Board: Takeda; Non-Financial Interests, Principal Investigator: Amgen; Non-Financial Interests, Principal Investigator: Bristol Meyer Squibb; Non-Financial Interests, Principal Investigator: MSD; Non-Financial Interests, Principal Investigator: Roche; Non-Financial Interests, Leadership Role: Swiss Academy for Clinical Cancer Research (SAKK); Non-Financial Interests, Principal Investigator: Takeda. A.R. Siebenhüner: Other, Advisory Role: AdvancedAcceleratorApp; Other, Advisory Role: Amgen; Other, Advisory Role: Bayer; Other, Advisory Role: BMS; Other, Advisory Role: Eisai; Other, Advisory Role: Lilly; Other, Advisory Role: MSD; Other, Advisory Role: Novartis; Other, Advisory Role: Pfizer; Other, Advisory Role: Servier; Other, Advisory Role: Sanofi; Other, Research Grant: Ipsen; Other, Research Grant: Roche; Other, Principal Investigator: Ipsen; Other, Principal Investigator: Roche. K.J. Dedes: Financial Interests, Personal, Advisory Role: Gilead, Daiichi, Exact Science, AstraZeneca, Roche, Novartis. H. Moch: Other, Advisory Role: Bayer; Other, Advisory Role: AstraZeneca; Other, Advisory Role: Ipsen Pharma; Other, Advisory Role: Visiopharm; Other, Advisory Role: Novartis; Other, Advisory Role: Roche; Other, Advisory Role: BMS; Other, Sponsor/Funding: Roche. C. Britschgi: Financial Interests, Personal, Advisory Role: AstraZeneca, Takeda, Pfizer, Roche, Janssen-Cilag, Boehringer Ingelheim; Financial Interests, Personal, Advisory Role, Travel, Accommodations: AstraZeneca, Takeda.