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Published on: April 11, 2016
NGS-Guided Precision Oncology in Breast Cancer and Gynecological Tumors-A Retrospective Molecular Tumor Board
Niklas Gremke1,2, Fiona R Rodepeter3, Julia Teply-Szymanski3
1Department of Gynecology, Gynecological Endocrinology and Oncology, University Hospital Gießen and Marburg Campus Marburg, Philipps-University, 35043 Marburg, Germany.
Abstract:
Background: Precision oncology treatments are being applied more commonly in breast and gynecological oncology through the implementation of Molecular Tumor Boards (MTBs), but real-world clinical outcome data remain limited. Methods: A retrospective analysis was conducted in patients with breast cancer (BC) and gynecological malignancies referred to our center's MTB from 2018 to 2023. The analysis covered patient characteristics, next-generation sequencing (NGS) results, MTB recommendations, therapy received, and clinical outcomes. Results: Sixty-three patients (77.8%) had metastatic disease, and forty-four patients (54.3%) had previously undergone three or more lines of systemic treatment. Personalized treatment recommendations were provided to 50 patients (63.3%), while 29 (36.7%) had no actionable target. Ultimately, 23 patients (29.1%) underwent molecular-matched treatment (MMT). Commonly altered genes in patients with pan-gyn tumors (BC and gynecological malignancies) included TP53 (n = 42/81, 51.9%), PIK3CA (n = 18/81, 22.2%), BRCA1/2 (n = 10/81, 12.3%), and ARID1A (n = 9/81, 11.1%). Patients treated with MMT showed significantly prolonged progression-free survival (median PFS 5.5 vs. 3.5 months, p = 0.0014). Of all patients who underwent molecular profiling, 13.6% experienced a major clinical benefit (PFSr ≥ 1.3 and PR/SD ≥ 6 months) through precision oncology. Conclusions: NGS-guided precision oncology demonstrated improved clinical outcomes in a subgroup of patients with gynecological and breast cancers.
Insights
Molecular Tumor Boards (MTBs) guide precision oncology for breast and gynecological cancers. Molecular-matched treatments improved progression-free survival, showing clinical benefit in a patient subgroup.
Area of Science:
- Oncology
- Genomics
- Clinical Trials
Background:
- Precision oncology is increasingly used in breast and gynecological cancers via Molecular Tumor Boards (MTBs).
- Limited real-world clinical outcome data exists for MTB-guided treatments.
- This study evaluates the impact of MTBs on patient outcomes in these cancer types.
Purpose of the Study:
- To assess the clinical utility and outcomes of precision oncology driven by Molecular Tumor Boards.
- To identify actionable targets and the efficacy of molecular-matched treatments.
- To analyze the impact of next-generation sequencing (NGS) on treatment decisions and patient survival.
Main Methods:
- Retrospective analysis of breast and gynecological cancer patients referred to an MTB (2018-2023).
- Evaluation of patient demographics, NGS results, MTB recommendations, therapies received, and clinical outcomes.
- Comparison of progression-free survival (PFS) between molecular-matched treatment (MMT) and other treatments.
Main Results:
- 50 patients (63.3%) received personalized treatment recommendations; 23 (29.1%) underwent MMT.
- Commonly altered genes included TP53, PIK3CA, BRCA1/2, and ARID1A.
- MMT significantly prolonged PFS (5.5 vs. 3.5 months, p=0.0014); 13.6% experienced major clinical benefit.
Conclusions:
- NGS-guided precision oncology via MTBs shows improved clinical outcomes in a subset of patients.
- Molecular-matched treatments offer a survival advantage for selected breast and gynecological cancer patients.
- MTBs are valuable in identifying actionable targets for personalized cancer therapy.
