149P - Assessing treatment options for gynaecological cancers (GC) using next-generation sequencing (NGS): A real-world analysis

Background

GC presents a clinical challenge due to its prevalence, diversity in treatment response and the emerging use of genome-driven cancer therapy (GT). NGS is key for tumor biology understanding and treatment tailoring.

Methods

Single-center retrospective analysis of GC patients (pts) with tumor molecular profile obtained from FFPE tumor samples within daily clinical practice and as a pre-screening of clinical trial (CT). We used FoundationOne®CDx (F1CDx) and TruSightTM Oncology 500 (TSO) panels as genomic tests. Pts characteristics, survival and NGS results were collected. Kaplan Meier method was perform to asses median overall survival (OS) and progression free survival (PFS).

Results

Characteristics are summarized in the table. 140 pts with GC were identified between October 2018 and June 2024. Pts received a median of 2 prior lines (1-4) and the majority were evaluated in the R/M setting (135/140 pts). The most frequent alteration identified was TP53 across all histologies, followed by PIK3CA, KRAS, ARID1A and PTEN. High copy numer variantion (CNV) were most commonly find in ERBB2 (12 pts). 23pts (16 %) received GT: 12/77 ovarian cancer (OC), 9/38 endometrial cancer (EC) and 1/18 cervical cancer (CC); 16/23 pts within CT and 7/23 within compassionate use (CU). With a median follow-up of 31 months (m), median PFS with GT were 4.3 m (CI95% 1.2-7.1) in OC, 6.5 m (CI95% 2.82-8.5) in EC and 11 m in the CC pt. Median OS from recurrent/metastatic disease (R/M) with GT were: 29 m (CI95% 17-72) in OC, 41 m (CI95% 11-75) in EC and 37 m (17.6-62.3) in CC. Table: 149P

Conclusions

Discussion NGS programs allows access to innovative therapies in a third of GC patients with an actionable target, and this may impact in OS. Further studies, including cost-effectiveness analysis, need to be performed with larger real-world cohorts.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

J. Martin-Liberal: Financial Interests, Personal, Invited Speaker: Astellas, Bristol Myers Squibb, MSD, Novartis, Pierre Fabre, Pfizer, Roche, Sanofi; Financial Interests, Personal, Advisory Board: Bristol Myers Squibb, Novartis, Pierre Fabre, Roche, Sanofi, Highlight Therapeutics; Financial Interests, Personal, Other, Travel grant: Bristol Myers Squibb, MSD, Novartis, Pierre Fabre, Pfizer, Roche, Ipsen, Merck. J.J. Soto Castillo: Financial Interests, Personal, Other, Travel, Accommodations, Expenses: Pfizer, Eisai, MSD, Seagen. P. Sàbat Viltró: Other, Personal, Other, Training: Lilly; Other, Personal, Other, Congress registration: Gilead. B. Pardo Búrdalo: Financial Interests, Personal, Invited Speaker: GSK, MSD, AstraZeneca, Pharma and; Other, Personal, Other, Grant for travel or attending meetings: GSK, MSD, Clovis. M. Gil Martín: Financial Interests, Personal, Invited Speaker: MSD, GSK, Clovis; Financial Interests, Personal, Advisory Board: AstraZeneca. All other authors have declared no conflicts of interest.