Abstract 84P
Background
Precision oncology through NGS can improve treatment (ttm) selection in advanced cancer patients (pts). NGS testing in mCRC within clinical research centres to promote cancer research and drug development, provide access to innovation and data collection, is strongly recommended by ESMO. The aim of this study is to assess the utility of an expanded genomic profiling programme in a single institution for mCRC pts to allow access to targeted therapies and clinical trials.
Methods
Retrospective analysis of a prospectively registered cohort of mCRC pts with tumour molecular profile assessed within daily clinical practice. OncomineTM Precision Assay (OPA) panel (Thermofisher®) was used as first genomic test for newly diagnosed pts, added to the analysis of mismatch repair (MMR) system status by usual techniques. TruSightTM Oncology 500 (TSO) panel (Illumina®) was used in refractory pts to search new ttm options in clinical trials.
Results
A total of 362 samples (298 primary tumours, 64 metastases) were analysed between March 2022 and March 2024, being 176 (48.6%) biopsies and 187 (51.7%) stage IV at diagnosis. OPA and TSO were used in 299 (82.6%) and 63 (17.4%) pts, respectively. Data were unavailable in 7 (1.9%) due to technical issues, but molecular testing could be done by single-gene assay. Median turnaround time was 12.8 days with OPA and 21.7 with TSO. Most frequent alterations were KRAS mutations (49.1%, G12C 2.2%); BRAF V600E was detected in 24 (6.6%) pts, eight (2.2%) had HER2 amplification and 3 (0.8%) NTRK fusion. MSI-high by NGS had a 100% correlation with other techniques, while 3/16 (18.7%) dMMR tumours were stable in TSO. Of 55 pts with an actionable target (ESCAT scores I and II), 33 (60%) were detected with OPA and 26 (47%) had access to targeted drugs and/or clinical trial, while 16 (29%) had no access due to unfavourable clinical status.
Conclusions
Our NGS programme in mCRC allows the optimization of tissue samples for initial molecular profile assessment and the access to innovative therapies in almost half of pts with an actionable target. Additional prospective studies including cost-effectiveness analysis are crucial before implementing NGS in the diagnosis setting of mCRC in health systems.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
J.C. Ruffinelli Rodriguez: Financial Interests, Personal, Invited Speaker: Amgen; Other, Travel and accommodation: MSD, Merck, Advanced Accelerator Applications. C. Santos Vivas: Financial Interests, Personal, Advisory Board: Sanofi, Amgen, Pierre Fabre; Financial Interests, Personal, Other, Travel and accommodation: Merck KGaA, Merck. All other authors have declared no conflicts of interest.