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The clinical impact of using complex molecular profiling strategies in routine oncology practice.

ABSTRACT: Molecular profiling and functional assessment of signalling pathways of advanced solid tumours are becoming increasingly available. However, their clinical utility in guiding patients' treatment remains unknown. Here, we assessed whether molecular profiling helps physicians in therapeutic decision making by analysing the molecular profiles of 1057 advanced cancer patient samples after failing at least one standard of care treatment using a combination of next-generation sequencing (NGS), immunohistochemistry (IHC) and other specific tests. The resulting information was interpreted and personalized treatments for each patient were suggested. Our data showed that NGS alone provided the oncologist with useful information in 10-50% of cases (depending on cancer type), whereas the addition of IHC/other tests increased extensively the usefulness of the information provided. Using internet surveys, we investigated how therapy recommendations influenced treatment choice of the oncologist. For patients who were still alive after the provision of the molecular information (76.8%), 60.4% of their oncologists followed report recommendations. Most treatment decisions (93.4%) were made based on the combination of NGS and IHC/other tests, and an approved drug- rather than clinical trial enrolment- was the main treatment choice. Most common reasons given by physicians to explain the non-adherence to recommendations were drug availability and cost, which remain barriers to personalised precision medicine. Finally, we observed that 27% of patients treated with the suggested therapies had an overall survival > 12 months. Our study demonstrates that the combination of NGS and IHC/other tests provides the most useful information in aiding treatment decisions by oncologists in routine clinical practice.

SUBMITTER: Laes JF

PROVIDER: S-EPMC5945513 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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The clinical impact of using complex molecular profiling strategies in routine oncology practice.

Laes Jean-François JF Aftimos Philippe P Barthelemy Philippe P Bellmunt Joaquim J Berchem Guy G Camps Carlos C Peñas Ramón de Las RL Finzel Ana A García-Foncillas Jesús J Hervonen Petteri P Wahid Ibrahim I Joensuu Timo T Kathan Louis L Kong Anthony A Mackay James J Mikropoulos Christos C Mokbel Kefah K Mouysset Jean-Loup JL Odarchenko Sergey S Perren Timothy J TJ Pienaar Rika R Regonesi Carlos C Alkhayyat Shadi Salem SS El Kinge Abdul Rahman AR Abulkhair Omalkhair O Galal Khaled Morsi KM Ghanem Hady H El Karak Fadi F Garcia Angel A Ghitti Gregori G Sadik Helen H

Oncotarget 20180417 29

Molecular profiling and functional assessment of signalling pathways of advanced solid tumours are becoming increasingly available. However, their clinical utility in guiding patients' treatment remains unknown. Here, we assessed whether molecular profiling helps physicians in therapeutic decision making by analysing the molecular profiles of 1057 advanced cancer patient samples after failing at least one standard of care treatment using a combination of next-generation sequencing (NGS), immunoh ...[more]

PMID: 29755651

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The clinical impact of using complex molecular profiling strategies in routine oncology practice.

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The clinical impact of using complex molecular profiling strategies in routine oncology practice.

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