Abstract 1953P
Background
Advanced therapy-refractory solid tumors bear a dismal prognosis. By analyzing the molecular profile of advanced tumors, targetable molecular alterations may allow a molecular-driven treatment approach. In this analysis, we evaluated feasibility as well as gender and molecular aspects of targeted therapy recommendations based on the respective molecular tumor profile after failure of all standard treatments in patients with different types of advanced solid tumors.
Methods
In this single center, real-world retrospective analysis of our precision medicine platform MONDTI, we described the molecular profile of 554 patients diagnosed with 17 different types of advanced solid tumors passing a threshold of 10 patients per tumor type. Tumor samples of the patients were examined using next-generation sequencing panels of mutation hotspots, MSI testing, immunohistochemistry, and cytogenetic analysis.
Results
In 304 cases (54.9% of all patients) a molecular driven targeted therapy approach could be recommended - mainly (in 86.2% of all cases) derived from the molecular characteristics determined by immunohistochemistry - with a recommendation rate above 50% in 12 tumor entities. The five highest rates for therapy recommendation per tumor classification were observed in urologic malignancies (90.0%), mesothelioma (78.6%), male reproductive cancers (71.4%), tumors of the central nervous system (67.8%), and head and neck cancer (65.9%). Tumor type (p=0.46), expression of p-mTOR (p=0.011), expression of EGFR (p=0.046), and expression of PD-L1 (p=0.023) had a significant impact on the targeted therapy recommendation rate. Targeted therapy recommendations were significantly more often issued for men (p = 0.015) due to gender specific differences in the molecular profile of patients with head and neck cancer and malignant mesothelioma.
Conclusions
This analysis demonstrated that precision medicine was feasible and provided the basis for molecular-driven therapy recommendations in patients with advanced therapy refractory solid tumors.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Medical University of Vienna.
Funding
Has not received any funding.
Disclosure
R. Bartsch: Honoraria (self): AstraZeneca; Honoraria (self): Celgene; Honoraria (self): Daiichi; Honoraria (self): Eisai; Honoraria (self): Eli Lilly and Company; Honoraria (self): MSD; Honoraria (self): Novartis; Honoraria (self): Pfizer; Honoraria (self): Pierre-Fabre; Honoraria (self): Roche; Honoraria (self): Bristol-Myers Squibb; Honoraria (self): Sandoz. M. Preusser: Honoraria (self): MSD; Honoraria (self): Roche; Honoraria (self): AstraZeneca; Honoraria (self): Bristol-Myers Squibb; Honoraria (self): Novartis; Honoraria (self): Lilly; Honoraria (self): Gerson Lehrman Group (GLG); Honoraria (self): CMC Contrast; Honoraria (self): GlaxoSmithKline; Honoraria (self): Mundipharma; Honoraria (self): BMJ Journals; Honoraria (self): MedMedia; Honoraria (self): AbbVie; Honoraria (self): Daiichi Sankyo; Honoraria (self): Medahead; Honoraria (self): Sanofi; Honoraria (self): Tocagen. G. Prager: Honoraria (self): Merck Serono; Honoraria (self): Roche; Honoraria (self): Sanofi; Honoraria (self): Amgen; Honoraria (self): Lilly; Honoraria (self): Servier; Honoraria (self): Taiho; Honoraria (self): Bayer; Honoraria (self): Halozyme; Honoraria (self): BMS; Honoraria (self): Celgene; Honoraria (self): Pierre Fabre; Honoraria (self): Shire. All other authors have declared no conflicts of interest.