Assessing tumor molecular profiling to guide treatments for patients with advanced female genital tract malignancy
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Philip Carter1, Costi Alifrangis2, Biancastella Cereser1, Pramodh Chandrasinghe1,3, Lisa Del Bel Belluz1, Christina Fotopoulou1, Andreja Frilling1, Thomas Herzog4,5, Nina Moderau1, Neha Tabassum1, Jonathan Krell1 and Justin Stebbing1
1Department of Surgery and Cancer, Imperial College, London, UK
2Department of Oncology, University College Hospital, London, UK
3Department of Surgery, University of Kelaniya, Kelaniya, Sri Lanka
4Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, USA
5University of Cincinnati Cancer Institute, University of Cincinnati, Cincinnati, USA
Philip Carter, email: [email protected]
Keywords: tumor profiling; female genital tract malignancy; cancer treatment
Abbreviations: ER: estrogen receptor; IHC: immunohistochemistry; OS: overall survival; PR: progesterone receptor
Received: July 29, 2017 Accepted: November 14, 2017 Published: December 27, 2017
Tumor molecular profiling has enabled selection of targeted therapies in a host of solid tumors. Here we used a retrospective clinical cohort, to evaluate the benefit of tailoring treatments for female genital tract malignancy, using tumor molecular profiles. Clinical outcome data for 112 patients was retrospectively separated into two groups. These either followed a matched treatment plan that incorporated at least one drug recommended according to their tumor profile and none that were expected to have no benefit (64 patients), or was unmatched with suggested treatments and received at least one drug that was anticipated to lack benefit for that tumor (48 patients).
In the group of patients whose drugs matched those recommended by molecular profiling of their tumor, their overall survival was 593 days on average, compared to 449 days for patients that did not; removing drugs predicted to have no benefit from treatment regimens received after profiling increased survival by 144 days on average (P = 0.0265). In the matched treatment group, 30% of patients had died by the last time of monitoring, whereas this was 40% in the unmatched group (P = 0.2778). The IHC biomarker for the progesterone receptor was demonstrated to be prognostic for survival.
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