Targeted Therapy Recommendations for Therapy Refractory Solid Tumors-Data from the Real-World Precision Medicine Platform MONDTI
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Published on: July 25, 2020
Hossein Taghizadeh1,2, Matthias Unseld1,2, Martina Spalt1,2
1Department of Medicine I, Division of Clinical Oncology, Medical University of Vienna, 1090 Vienna, Austria.
Abstract:
Advanced therapy-refractory solid tumors bear a dismal prognosis and constitute a major challenge in offering effective treatment strategies. In this real-world retrospective analysis of our precision medicine platform MONDTI, we describe the molecular profile of 554 patients diagnosed with 17 different types of advanced solid tumors after failure of all standard treatment options. In 304 cases (54.9% of all patients), a molecular-driven targeted therapy approach could be recommended, with a recommendation rate above 50% in 12 tumor entities. The three highest rates for therapy recommendation per tumor classification were observed in urologic malignancies (90.0%), mesothelioma (78.6%), and male reproductive cancers (71.4%). Tumor type (p = 0.46), expression of p-mTOR (p = 0.011), expression of EGFR (p = 0.046), and expression of PD-L1 (p = 0.023) had a significant impact on the targeted therapy recommendation rate. Therapy recommendations were significantly more often issued for men (p = 0.015) due to gender-specific differences in the molecular profiles of patients with head and neck cancer and malignant mesothelioma. This analysis demonstrates that precision medicine was feasible and provided the basis for molecular-driven therapy recommendations in patients with advanced therapy refractory solid tumors.
Insights
Precision medicine identified targeted therapy for over half of advanced solid tumor patients refractory to standard treatments. Molecular profiling informed treatment recommendations across diverse cancer types, improving therapeutic options.
Area of Science:
- Oncology
- Genomics
- Precision Medicine
Background:
- Advanced therapy-refractory solid tumors present significant treatment challenges with poor prognoses.
- Standard treatment options often fail for patients with advanced solid tumors.
Purpose of the Study:
- To analyze the molecular profiles of patients with advanced solid tumors resistant to therapy.
- To assess the feasibility and impact of a precision medicine platform (MONDTI) in guiding targeted therapy recommendations.
Main Methods:
- Retrospective analysis of 554 patients with 17 types of advanced solid tumors.
- Evaluation of molecular profiles to identify actionable targets for therapy.
- Analysis of factors influencing targeted therapy recommendation rates.
Main Results:
- A molecular-driven targeted therapy approach was recommended for 54.9% of patients.
- High recommendation rates were observed in urologic malignancies (90.0%), mesothelioma (78.6%), and male reproductive cancers (71.4%).
- Tumor type, p-mTOR, EGFR, and PD-L1 expression significantly impacted recommendation rates; men received recommendations more often.
Conclusions:
- Precision medicine is feasible for patients with advanced, therapy-refractory solid tumors.
- Molecular profiling provides a basis for recommending targeted therapies in this challenging patient population.
- Identified molecular markers and tumor types can guide personalized treatment strategies.
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