Genomic actionability and matched targeted therapy in a decade-long institutional precision medicine program for...

Area of Science:

• Oncology
• Genomics
• Translational Medicine

Background:

• Precision oncology has advanced cancer treatment but faces disparities in genomic profiling and therapy access.
• The Vall d'Hebron Institute of Oncology (VHIO) established a precision medicine program (PMP) to address these challenges.

Purpose of the Study:

• To evaluate the VHIO PMP's performance over a decade (2014-2024).
• To assess the trends in actionable alteration detection and the utilization of matched therapies.

Main Methods:

• Retrospective analysis of patients in the VHIO PMP (2014-2024).
• Review of tumor profiling outcomes, focusing on European Society for Medical Oncology Scale for Clinical Actionability of Molecular Targets (ESCAT) classifications.
• Standardized interpretation and therapy prioritization via multidisciplinary molecular tumor boards.
• Key performance indicators (KPIs) included detection of ESCAT tiers I-IV alterations and receipt of matched therapies.

Main Results:

• Over 13,700 molecular profiles were analyzed in 12,168 patients.
• Actionable alteration detection increased from 10.1% (2014) to 53.1% (2024).
• Molecularly matched therapy use rose from 1% (2014) to 14.2% (2024), with 23.5% of patients with actionable alterations receiving targeted treatments.
• Liquid biopsies enhanced detection and therapy access; clinical trial eligibility criteria evolved.

Conclusions:

• The VHIO PMP demonstrated success in actionable alteration detection and matched therapy provision.
• Integrated programs with KPI monitoring are vital for sustained performance in precision oncology.
• Ongoing advancements in diagnostics and molecularly guided clinical trials are essential for future progress.