Oncotarget

Research Papers:

The clinical impact of using complex molecular profiling strategies in routine oncology practice

Jean-François Laes _, Philippe Aftimos, Philippe Barthelemy, Joaquim Bellmunt, Guy Berchem, Carlos Camps, Ramón de las Peñas, Ana Finzel, Jesús García-Foncillas, Petteri Hervonen, Ibrahim Wahid, Timo Joensuu, Louis Kathan, Anthony Kong, James Mackay, Christos Mikropoulos, Kefah Mokbel, Jean-Loup Mouysset, Sergey Odarchenko, Timothy J. Perren, Rika Pienaar, Carlos Regonesi, Shadi Salem Alkhayyat, Abdul Rahman El Kinge, Omalkhair Abulkhair, Khaled Morsi Galal, Hady Ghanem, Fadi El Karak, Angel Garcia, Gregori Ghitti and Helen Sadik

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Oncotarget. 2018; 9:20282-20293. https://doi.org/10.18632/oncotarget.24757

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Abstract

Jean-François Laes1, Philippe Aftimos2, Philippe Barthelemy3, Joaquim Bellmunt4,5, Guy Berchem6, Carlos Camps7, Ramón de las Peñas8, Ana Finzel1, Jesús García-Foncillas9, Petteri Hervonen10, Ibrahim Wahid11, Timo Joensuu10, Louis Kathan12, Anthony Kong13, James Mackay14, Christos Mikropoulos15, Kefah Mokbel16, Jean-Loup Mouysset17, Sergey Odarchenko18, Timothy J. Perren19, Rika Pienaar12, Carlos Regonesi20, Shadi Salem Alkhayyat21, Abdul Rahman El Kinge22, Omalkhair Abulkhair22, Khaled Morsi Galal23, Hady Ghanem24, Fadi El Karak25, Angel Garcia26, Gregori Ghitti1 and Helen Sadik1

1OncoDNA SA, Office: 1, Rue Louis Breguet, Gosselies, Belgium

2Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium

3Hôpitaux Universitaires de Strasbourg, Strasbourg, France

4Institut Hospital del Mar d’Investigacions Médiques, Barcelona, Spain

5Harvard University, Cambridge, Massachusetts, USA

6Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg

7Consorcio Hospital General Universitario de Valencia, Valencia, Spain

8Consorcio Hospitalario Provincial de Castellón, Castellón, Spain

9Fundación Jimenez Díaz, IDC Salud, Madrid, Spain

10Docrates Cancer Center, Helsinki, Finland

11Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia

12Cancercare, Cape Town, South Africa

13University Hospital Birmingham NHS Trust, University of Birmingham, Edgbaston, UK

14The London Breast Clinic, London, UK

15Kent Oncology Centre, Kent, UK

16The Princess Grace Hospital, London, UK

17Clinique Rambot-Provençale, Aix-en-Provence, France

18Vinnitsa Regional Clinical Oncology Center, Vinnitsa, Ukraine

19St. James University Hospital, Leeds, UK

20Clinica Las Condes, Santiago, Chile

21King Abdulaziz University Hospital, Jeddah, Saudi Arabia

22Specialized Medical Center Hospital, Riyadh, Saudi Arabia

23Kasr El-Aini Hospital, Cairo University, Cairo, Egypt

24Lebanese American University Medical Center-Rizk Hospital (LAUMC-RH), Beirut, Lebanon

25Saint Joseph University, Hôtel-Dieu de France University Hospital, Beirut, Lebanon

26Nuffield Hospital, Chester, UK

Correspondence to:

Jean-François Laes, email: jf.laes@oncodna.com

Keywords: molecular profiling; solid tumour; precision medicine; next-generation sequencing; therapeutic decision making in oncology

Received: December 20, 2017     Accepted: March 12, 2018     Published: April 17, 2018

ABSTRACT

Molecular profiling and functional assessment of signalling pathways of advanced solid tumours are becoming increasingly available. However, their clinical utility in guiding patients’ treatment remains unknown. Here, we assessed whether molecular profiling helps physicians in therapeutic decision making by analysing the molecular profiles of 1057 advanced cancer patient samples after failing at least one standard of care treatment using a combination of next-generation sequencing (NGS), immunohistochemistry (IHC) and other specific tests. The resulting information was interpreted and personalized treatments for each patient were suggested. Our data showed that NGS alone provided the oncologist with useful information in 10–50% of cases (depending on cancer type), whereas the addition of IHC/other tests increased extensively the usefulness of the information provided. Using internet surveys, we investigated how therapy recommendations influenced treatment choice of the oncologist. For patients who were still alive after the provision of the molecular information (76.8%), 60.4% of their oncologists followed report recommendations. Most treatment decisions (93.4%) were made based on the combination of NGS and IHC/other tests, and an approved drug- rather than clinical trial enrolment- was the main treatment choice. Most common reasons given by physicians to explain the non-adherence to recommendations were drug availability and cost, which remain barriers to personalised precision medicine. Finally, we observed that 27% of patients treated with the suggested therapies had an overall survival > 12 months. Our study demonstrates that the combination of NGS and IHC/other tests provides the most useful information in aiding treatment decisions by oncologists in routine clinical practice.


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