129P - NGS prescreening program for refractory solid tumors outside standard indications in a public network of cancer centers

Background

In some Spanish regions, NGS is now publicly funded for certain tumor types with approved targeted therapies (e.g. NSCLC) or molecular diagnosis (e.g. sarcomas) as standard of care (SOC). Outside those indications, patients (pts) do not have access to NGS, limiting treatment (tx) opportunities. The Catalan Institute of Oncology (ICO) network of public cancer centers has implemented a centralized NGS prescreening program through institutional grants outside SOC indications in order to broaden tx options.

Methods

Retrospective cohort analysis of refractory solid tumors pts referred to the multicentric ICO Phase 1 Unit who underwent prescreening with the NGS panel TrueSightOncology500. We assessed the percentage of pts treated based on identified alterations, overall response rate (ORR) by RECIST1.1 and clinical benefit rate (CBR) [complete/partial response (PR) or stable disease for >4 months]. Progression-free and overall survival (PFS, OS) were also evaluated.

Results

From MAR22 to MAR24, 249 pts were included at 3 ICO centers: 54% female; most frequent tumors being colorectal (18.1%), urothelial (8%), endometrial (7.6%), ovarian (6.4%) and high-grade gliomas (6.4%); median prior lines of tx was 2 (0-7). 226 pts (95%) had some molecular alteration and 22 pts (10%) received tx accordingly within clinical trials or as compassionate use. Main targeted findings were HER2 amp, MSI, KRAS mut G12C, high TMB (>10 mut/Mb) and BRCA mut, among others (Table). From 14 evaluable pts, 1 achieved PR. CBR was 36% (5/14). Median PFS and OS were 2.9 (0.7-8.1) and 5.85 (1.4-16.6) months, respectively. Table: 129P

Conclusions

In our experience, a coordinated multicentric NGS prescreening program outside publicly funded SOC indications is feasible and useful, allowing access to additional tx in 10% of cases. Better selection of pts and wider availability of clinical trials will presumably increase clinical benefit in the next few years.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

The authors.

Funding

Catalan Institute of Oncology.

Disclosure

P. Sàbat Viltró: Other, Personal, Other, Training: Lilly; Other, Personal, Other, Congress registration: Gilead. J.J. Soto Castillo: Financial Interests, Personal, Other, Travel, Accommodations, Expenses: Pfizer, Eisai, MSD, Seagen. M. Calvo: Financial Interests, Personal, Advisory Board: Roche, Eisai; Financial Interests, Personal, Invited Speaker: Roche, AstraZeneca; Financial Interests, Personal, Other, Safety Phase I trial: Nerviano. M. Oliva Bernal: Financial Interests, Personal, Invited Speaker: Merck, MSD, BMS, MSD; Financial Interests, Personal, Advisory Board: Merck, MSD; Financial Interests, Personal, Invited Speaker, Teaching activities: MSD, Merck; Financial Interests, Personal, Other, IDMC: Transgene; Financial Interests, Personal and Institutional, Funding: Roche; Financial Interests, Institutional, Invited Speaker: ALX Oncology, MSD, ISA Therapeutics BV, Roche, Ayala Therapeutics, AbbVie, Bayer, Boehringer Ingelheim, Merck, Debiopharm, Seagen, Gilead, Beigene, Nykode; Financial Interests, Institutional, Funding: GSK; Non-Financial Interests, Institutional, Product Samples: Roche. J.C. Ruffinelli Rodriguez: Financial Interests, Personal, Invited Speaker: Amgen; Other, Personal, Other, Travel and Accommodation: MSD, Merck, Advanced Accelerator Applications, Esteve. R. Villanueva Vazquez: Financial Interests, Personal, Advisory Board: Seattle Genetics; Financial Interests, Personal, Other, Congress attendance registration: Pfizer, Novartis, Gilead, AstraZeneca, Daiichi Sankyo/AstraZeneca. C. Fina Planas: Financial Interests, Personal, Invited Speaker: BMS, Ipsen; Non-Financial Interests, Personal, Principal Investigator: Janssen. C. Hierro: Financial Interests, Personal, Invited Speaker: MSD, Lilly, AstraZeneca; Financial Interests, Personal, Research Grant, Principal Investigator of Merck Research Grant in Personalized Medicine 2020: Merck; Non-Financial Interests, Personal, Principal Investigator, Clinical Trial: BMS, Jazz Therapeutics, ALX Oncology, AstraZeneca, MSD; Other, Personal, Other, Travel fees: BMS, Amgen, Roche, Merck. M. Gil Martín: Financial Interests, Personal, Invited Speaker: MSD, GSK, Clovis; Financial Interests, Personal, Advisory Board: AstraZeneca. 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. All other authors have declared no conflicts of interest.