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Clinical Application of Targeted Deep Sequencing in Solid-Cancer Patients and Utility for Biomarker-Selected Clinical

Seung Tae Kim1, Kyoung-Mee Kim2,3, Nayoung K D Kim4

  • 1Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

The Oncologist
|July 14, 2017
PubMed

Insights

Molecular profiling of refractory cancer patients using a gene panel test increased clinical trial enrollment. This precision medicine approach identified actionable genomic alterations, guiding 44% of patients to potentially targetable therapies.

Area of Science:

  • Oncology
  • Genomics
  • Translational Medicine

Background:

  • Molecular profiling of actionable mutations in refractory cancer patients can enable precision medicine.
  • Individualized therapies can be guided by genomic profiling.
  • Molecular screening programs aim to match participants to clinical trials based on sequencing reports.

Purpose of the Study:

  • To assess the utility of a custom target-enrichment panel for interrogating various genomic alterations in cancer patients.
  • To determine the rate of actionable biomarkers and potentially targetable genomic alterations in a cohort of refractory cancer patients.
  • To evaluate the impact of panel-based sequencing on clinical trial enrollment for metastatic cancer patients.

Main Methods:

  • A custom 381-gene cancer-panel was used for molecular profiling.
  • The panel interrogated single-nucleotide variants, insertions/deletions, copy number variants, and gene fusions.
  • 654 patients consented, 588 passed quality control, and 418 were included in the final analysis.

Main Results:

  • 55 patients (12%) harbored a biomarker guiding them to a biomarker-selected clinical trial.
  • 184 patients (44%) had at least one potentially targetable genomic alteration.
  • The panel-based sequencing program increased trial enrollment for metastatic cancer patients.

Conclusions:

  • Panel-based molecular profiling is effective in identifying actionable targets for precision medicine in refractory cancer.
  • This approach enhances the rate of enrollment in biomarker-selected clinical trials.
  • The guidance percentage to matched trials is expected to increase with more biomarker-selected trials available.
Keywords:
Clinical trialsMetastatic cancerMolecular screeningNext‐generation sequencing

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