71P - Molecular Tumor Board at the European Institute of Oncology: An early Italian precision oncology experience

Background

Precision oncology personalizes treatments for cancer patients, aiming to improve their clinical outcomes. ESMO Scale for Clinical Actionability of Molecular Targets (ESCAT) allows evidence-based evaluation of genomic findings. Molecular tumor boards (MTBs) multi-disciplinary expertise enables ESCAT implementation and personalized treatment choice.

Methods

We retrospectively reviewed outcomes of patients discussed at European Institute of Oncology MTB between June 2019 and June 2022. We performed descriptive statistics and survival analysis comparing patients that received molecularly-matched treatments (MMT) and non-matched treatments (nMMT).

Results

MTB discussed 251 patients with cancer encompassing 26 different primary cancer types. Breast cancer accounted for 25.5% of the total. 188 (74.6%) patients had at least one actionable alteration. After MTB discussion, 76 patients received MMT while 76 received nMMT. Patients receiving MMT displayed higher overall response rate (37.3% vs 12.9%), median progression-free-survival (PFS 5.8 months, 95% CI 4.1–7.5 vs 3.6 months, 95% CI 2.5–4.8, p=0.041; HR 0.679, 95% CI 0.467–0.987) and median overall-survival (mOS 35.1 months, 95% CI not evaluable vs 8.5 months, 95% CI 3.8 – 13.2; HR 0.431, 95% CI 0.250 – 0.744, p=0.002). Superiority in OS and PFS persisted in multivariable models. Among 61 pretreated patients receiving MMT, 37.5% had superior PFS compared to the prior line (PFS2/PFS1 ratio ≥ 1.3). Higher OS (p=0.001) and PFS (p=0.049) were observed for patients with higher actionability evidence (ESCAT tier I) alterations, while no difference was observed in lower evidence levels. Table: 71P
Most frequent actionable genes

Conclusions

We report real-world data of the first Italian experience of MTB application in clinical practice. Our work shows that MTBs can yield valuable clinical benefit in terms of OS and PFS. Biomarkers with lower actionability ESCAT level appear to be linked to lower clinical benefit.

Clinical trial identification

This study is approved by IEO Ethical Committee with the reference number UID 3572.

Editorial acknowledgement

None

Legal entity responsible for the study

E. Crimini, M. Repetto.

Funding

Has not received any funding.

Disclosure

E. Guerini-Rocco: Financial Interests, Personal, Advisory Role: AstraZeneca, GSK, Roche, Termo Fisher; Financial Interests, Personal, Advisory Board: Novartis. C. Criscitiello: Financial Interests, Personal, Invited Speaker: Pfizer, Novartis, Eli Lilly, Roche, Gilead; Financial Interests, Personal, Advisory Board: MSD, Seagen, AstraZeneca, Daiichi Sankyo. A. Esposito: Financial Interests, Personal, Speaker’s Bureau: Novartis. G. Curigliano: Financial Interests, Personal, Invited Speaker: Roche, AstraZeneca, Daiichi Sankyo, Novartis, Pfizer; Financial Interests, Personal, Advisory Board: Ellipsis, Roche, AstraZeneca, Daiichi Sankyo, Lilly, Pfizer, Veracyte, BMS, Merck, Exact Sciences, Celcuity; Financial Interests, Institutional, Research Grant, Investigator Initiated Trial: Merck; Financial Interests, Institutional, Funding, Phase I studies: BMS, Novartis, AstraZeneca, Daiichi Sankyo, Roche, Blueprint Medicine, Kymab, Astellas, Sanofi, Philogen; Financial Interests, Institutional, Invited Speaker, Phase I clinical basket trial: Relay Therapeutics; Non-Financial Interests, Personal, Officer, Italian National Health Council as Advisor for Ministry of Health: Consiglio Superiore di Sanità; Non-Financial Interests, Personal, Advisory Role, Member of the Scientific Council. Patient Advocacy Association: Europa Donna; Non-Financial Interests, Personal, Advisory Role, Cancer Research Foundation: Fondazione Beretta; Non-Financial Interests, Personal, Invited Speaker, No compensation for this role. This a public national company for cancer prevention: Lega Italiana Lotta ai Tumori; Non-Financial Interests, Personal, Officer, Member of the Advisory Council: EUSOMA. All other authors have declared no conflicts of interest.