Abstract 708P
Background
Next generation sequencing (NGS) has become widely available but molecular profiling guided therapy (MGT) has not been established in the real world due to a lack of available therapies and expertise to interpret and match treatment in Korea.
Methods
Patients with advanced solid tumors without remaining standard treatment were enrolled. Virtual, central molecular tumor boards (cMTB) reviewed patients’ NGS reports and recommended clinical trials or investigational medicinal products (IMPs) as previously described (https://doi.org/10.1016/j.esmoop.2022.100653). Primary variable was to assess the proportion of patients with actionable genomic alterations and patients receiving MGT as MTB recommendations. Other variables were duration of treatment (DoT), overall response rate (ORR), disease control rate (DCR) and safety.
Results
From Feb 2021 to Feb 2022, 198 patients were enrolled. Median time from case submission to MTB discussion was 7 days (range, 2-20) and concordance rate between pre-MTB physicians’ choice and MTB recommendations were 60.1% (119/198). A total of 107 (54.0%) received IMPs based on MTB decision (32, TE; 21, AZ; 14, TP; 13, BE; 8, AP; 6, CA; 5, DT; 4, AL; 3, EL; 1, BV). ORR and DCR were 13.3% (1 CR, 9 PR, 45 SD, and 20 PD), and 73.3%. DoT was 3.6 months (95% CI, 2.8-5.0) and 4 months DoT rate (4MDoTR) was 45.5%. DoT>12 months were observed in 10 (9.3%). TE showed a durable DoT, regardless of ERBB2 amplification and mutation (5.8 and 4.0 months), previous exposure of anti-HER2 targeted agents (4.0(No) vs. 5.4 months (Yes)), and high (6>) vs. low (6<) copy number variation (4.0 and 8.0 months).
Table: 708P
| IMPs | ORR | DCR | 4MDoTR | DoT(months) |
| Alectinib (AL) | 33.3% | 33.3% | 50.0% | 3.4 |
| Alpelisib (AP) | 50.0% | 50.0% | 42.9% | 1.4 |
| Atezolizumab (AZ) | 21.4% | 57.1% | 30.0% | 1.9 |
| Bevacizumab (BV) | 0.0% | 100.0% | 100.0% | 8.3 |
| Bevacizumab + erlotinib (BE) | 9.1% | 54.5% | 33.3% | 3.4 |
| Capecitabine (CA) | 0.0% | 100.0% | 0.0% | 1.6 |
| Dabrafenib + trametinib (DT) | 50.0% | 100.0% | 60.0% | 6.9 |
| Erlotinib (EL) | 0.0% | 100.0% | 66.7% | 6.5 |
| Trastuzumab and pertuzumab (TP) | 0.0% | 100.0% | 57.1% | 4.6 |
| Trastuzumab emtansine (TE) | 8.3% | 75.0% | 56.7% | 4.2 |
| All | 13.3% | 73.3% | 45.5% | 3.6 |
Conclusions
KOSMOS suggested the feasibility of nationwide cMTB guided MGT and also showed modest ORR, and a promising DCR in heavily pre-treated patients. KOSMOS-II (NCT05525858) is currently underway to confirm this in larger number of patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Korean Society of Medical Oncology, Korean Cancer Study Group.
Funding
Roche. And this study was supported by the National R&D Program for Cancer Control through the National Cancer Center(NCC) funded by the Ministry of Health&Welfare, Republic of Korea (HA22C0052).
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
689P - DB-1305 (a Trop-2 targeted antibody-drug-conjugate [ADC]) in patients (pts) with advanced solid tumors: Preliminary clinical results from the phase (Ph) I/IIa study
Presenter: Omkar Marathe
Session: Poster session 17
690P - Ifinatamab deruxtecan (I-DXd; DS-7300) in patients with advanced solid tumors: Updated clinical and biomarker results from a phase I/II study
Presenter: Manish R Patel
Session: Poster session 17
691P - Efficacy of ABBV-400 monotherapy in patients with MET gene amplified advanced solid tumors
Presenter: John Strickler
Session: Poster session 17
692P - First-in-human study of ELU001, a targeted nanoparticle drug conjugate, in subjects with folate receptor α (FRα) overexpressing solid tumors
Presenter: Wen wee Ma
Session: Poster session 17
693P - Preclinical activity of HLX43, a PD-L1-targeting ADC, in multiple PD-1/PD-L1 refractory/resistant models
Presenter: Yongqiang Shan
Session: Poster session 17
694P - Full efficacy analysis of phase I/II trial investigating bexmarilimab, a novel macrophage-guided immunotherapy in refractory solid tumors
Presenter: Petri Bono
Session: Poster session 17
695P - A phase I/Ib study evaluating the safety and tolerability of NIZ985 alone and in combination with spartalizumab (anti–PD-1) in patients (pts) with solid tumors or lymphoma
Presenter: Elena Garralda
Session: Poster session 17
696P - SIM1811-03 (SIM0235), an anti-tumor necrosis factor receptor-2 (TNFR2) monoclonal antibody, in patients with advanced solid tumor and/or cutaneous T cell lymphomas (CTCL): Preliminary results from an on-going first-in-human phase I trial in China
Presenter: Furong Liu
Session: Poster session 17