Multicenter experience with large panel next-generation sequencing in patients with advanced solid cancers in Japan

Area of Science:

• Oncology
• Genomics
• Precision Medicine

Background:

• Next-generation sequencing (NGS) is increasingly used in clinical oncology globally.
• Japan is establishing systems for routine NGS application in clinical practice.
• The Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT) assay was introduced in Japan.

Purpose of the Study:

• To report the initial experience of implementing MSK-IMPACT in Japan.
• To assess the feasibility and utility of tumor profiling in Japanese cancer patients.
• To identify challenges and opportunities for precision medicine in Japan.

Main Methods:

• MSK-IMPACT assay was used for tumor profiling.
• Data from 68 patients across two Japanese institutions were analyzed.
• The study period was from June 2016 to October 2017.

Main Results:

• The MSK-IMPACT assay achieved a 94.1% success rate (64/68 patients).
• Common cancer types included endometrial, pancreatic, and colorectal cancers.
• 25% of patients had actionable genetic alterations, but clinical trial enrollment was difficult due to organ-specific limitations.
• One patient with microsatellite instability-high status responded to pembrolizumab.

Conclusions:

• NGS tumor profiling and genomically matched therapy show promise for precision medicine in Japan.
• High costs and system integration challenges need to be addressed for widespread adoption.
• Sharing initial experiences is crucial for advancing precision medicine in the Japanese healthcare system.