PURPOSE: Precision oncology has transformed the management of advanced cancers through implementation of advanced molecular profiling technologies to identify increasingly defined subsets of patients and match them to appropriate therapy. We report outcomes of a prospective molecular profiling study in a high-volume Asian tertiary cancer center. PATIENTS AND METHODS: Patients with advanced cancer were enrolled onto a prospective protocol for genomic profiling, the Individualized Molecular Profiling for Allocation to Clinical Trials Singapore study, at the National Cancer Center Singapore. Primary objective was to identify molecular biomarkers in patient's tumors for allocation to clinical trials. The study commenced in February 2012 and is ongoing, with the results of all patients who underwent multiplex next-generation sequencing (NGS) testing until December 2018 presented here. The results were discussed at a molecular tumor board where recommendations for allocation to biomarker-directed trials or targeted therapies were made. RESULTS: One thousand fifteen patients were enrolled with a median age of 58 years (range 20-83 years). Most common tumor types were lung adenocarcinoma (26%), colorectal cancer (15%), and breast cancer (12%). A total of 1,064 NGS assays were performed, on fresh tumor tissue for 369 (35%) and archival tumor tissue for 687 (65%) assays. TP53 (39%) alterations were most common, followed by EGFR (21%), KRAS (14%), and PIK3CA (10%). Of 405 NGS assays with potentially actionable alterations, 111 (27%) were allocated to a clinical trial after molecular tumor board and 20 (4.9%) were enrolled on a molecularly matched clinical trial. Gene fusions were detected in 23 of 311 (7%) patients tested, including rare fusions in new tumor types and known fusions in rare tumors. CONCLUSION: Individualized Molecular Profiling for Allocation to Clinical Trials Singapore demonstrates the feasibility of a prospective broad molecular profiling program in an Asian tertiary cancer center, with the ability to develop and adapt to a dynamic landscape of precision oncology.
PURPOSE: Precision oncology has transformed the management of advanced cancers through implementation of advanced molecular profiling technologies to identify increasingly defined subsets of patients and match them to appropriate therapy. We report outcomes of a prospective molecular profiling study in a high-volume Asian tertiary cancer center. PATIENTS AND METHODS: Patients with advanced cancer were enrolled onto a prospective protocol for genomic profiling, the Individualized Molecular Profiling for Allocation to Clinical Trials Singapore study, at the National Cancer Center Singapore. Primary objective was to identify molecular biomarkers in patient's tumors for allocation to clinical trials. The study commenced in February 2012 and is ongoing, with the results of all patients who underwent multiplex next-generation sequencing (NGS) testing until December 2018 presented here. The results were discussed at a molecular tumor board where recommendations for allocation to biomarker-directed trials or targeted therapies were made. RESULTS: One thousand fifteen patients were enrolled with a median age of 58 years (range 20-83 years). Most common tumor types were lung adenocarcinoma (26%), colorectal cancer (15%), and breast cancer (12%). A total of 1,064 NGS assays were performed, on fresh tumor tissue for 369 (35%) and archival tumor tissue for 687 (65%) assays. TP53 (39%) alterations were most common, followed by EGFR (21%), KRAS (14%), and PIK3CA (10%). Of 405 NGS assays with potentially actionable alterations, 111 (27%) were allocated to a clinical trial after molecular tumor board and 20 (4.9%) were enrolled on a molecularly matched clinical trial. Gene fusions were detected in 23 of 311 (7%) patients tested, including rare fusions in new tumor types and known fusions in rare tumors. CONCLUSION: Individualized Molecular Profiling for Allocation to Clinical Trials Singapore demonstrates the feasibility of a prospective broad molecular profiling program in an Asian tertiary cancer center, with the ability to develop and adapt to a dynamic landscape of precision oncology.
Authors: J Mateo; D Chakravarty; R Dienstmann; S Jezdic; A Gonzalez-Perez; N Lopez-Bigas; C K Y Ng; P L Bedard; G Tortora; J-Y Douillard; E M Van Allen; N Schultz; C Swanton; F André; L Pusztai Journal: Ann Oncol Date: 2018-09-01 Impact factor: 32.976
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Authors: Filippo Pietrantonio; Federica Di Nicolantonio; Alexa B Schrock; Jeeyun Lee; Sabine Tejpar; Andrea Sartore-Bianchi; Jaclyn F Hechtman; Jason Christiansen; Luca Novara; Niall Tebbutt; Giovanni Fucà; Carlotta Antoniotti; Seung Tae Kim; Danielle Murphy; Rosa Berenato; Federica Morano; James Sun; Bosun Min; Philip J Stephens; Marissa Chen; Luca Lazzari; Vincent A Miller; Robert Shoemaker; Alessio Amatu; Massimo Milione; Jeffrey S Ross; Salvatore Siena; Alberto Bardelli; Siraj M Ali; Alfredo Falcone; Filippo de Braud; Chiara Cremolini Journal: J Natl Cancer Inst Date: 2017-12-01 Impact factor: 13.506
Authors: Valerie Heong; Nicholas L Syn; Xiao Wen Lee; Nur Sabrina Sapari; Xue Qing Koh; Zul Fazreen Adam Isa; Joey Sy Lim; Diana Lim; Brendan Pang; Yee Liang Thian; Lai Kuan Ng; Andrea L Wong; Ross Andrew Soo; Wei Peng Yong; Cheng Ean Chee; Soo-Chin Lee; Boon-Cher Goh; Richie Soong; David S P Tan Journal: Int J Cancer Date: 2017-10-17 Impact factor: 7.396