1649P - Comprehensive genomic profiling contributes to the prognosis of patients with advanced pancreatic cancer

Background

Precision medicine for pancreatic cancer (PC) is one of the promising treatment strategies. However, only a few patients can receive genotype-matched treatments for the low detection rate of actionable genomic alterations, therefore the clinical utility of comprehensive genomic profiling (CGP) is still unknown. On the other hand, CGP gives us a lot of information such as prognosis, future eligibility for genotype-matched clinical trials, and it may affect physician’s treatment strategies. The present study was to investigate the contribution to prognosis of CGP, and its appropriate timing in the treatment of advanced PC.

Methods

This was a single-center, retrospective cohort study. Patients who were diagnosed as recurrent or metastatic PC with adenocarcinoma or adenosquamous carcinoma and underwent systemic chemotherapy between April 2018 and March 2022 were recruited. We reviewed the medical records and collected data of patient characteristics, survivals, and genomic information. We compared overall survival (OS) according to those who had received CGP (CGP group) or not (non-CGP group), and those who had performed CGP before or after initial chemotherapy.

Results

A total of 107 patients were eligible, in which 47 patients had received CGP. Patient characteristics were not statistically different between two groups except for age. OS was significantly longer in CGP group than non-CGP group (median, 29.7 vs 13.4 months; hazard ratio [HR], 0.51; 95% confidence interval [CI], 0.30–0.89; P < 0.017). OS tended to be longer in patients who had received CGP before the initiation of systemic chemotherapy than those who had received CGP after initial chemotherapy (median, 40.1 vs 24.0 months; HR, 0.29; 95% CI, 0.085–1.02; P=0.054). Actionable genomic alterations were detected in 16 patients (34.0%), whereas genotype-matched treatments were implemented for five patients (10.6%).

Conclusions

In the present study, OS was prolonged in patients who had undergone CGP irrespective of implementation of genotype-matched treatments, suggesting that CGP could help physicians to select the optimal treatment strategies for advanced PC in clinical practice. Given the extremely poor prognosis of the disease, earlier timing of CGP is considered.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.