Oncologist uptake of comprehensive genomic profile guided targeted therapy
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Mary K. Nesline1, Paul DePietro1, Grace K. Dy2, Amy Early2, Antonios Papanicolau-Sengos1, Jeffrey M. Conroy1,4, Felicia L. Lenzo1, Sean T. Glenn1, Hongbin Chen2, Anne Grand’Maison2, Patrick Boland2, Marc S. Ernstoff2, Igor Puzanov2, Stephen Edge7, Stacey Akers2, Mateusz Opyrchal2, Gurkamal Chatta2, Kunle Odunsi2, Peter Frederick6, Shashikant Lele6, Mark Gardner1 and Carl Morrison1,3,5
1 OmniSeq Inc., Buffalo, NY 14203, USA
2 Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
3 Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
4 Center for Personalized Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
5 Cancer Genetics and Genomics, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
6 Division of Gynecologic Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
7 Department of Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
|Mary K. Nesline,||email:||Mary.Nesline@OmniSeq.com|
Keywords: comprehensive genomic profiling; targeted therapy; clinical decision making; next-generation sequencing; real world data
Received: March 19, 2019 Accepted: June 19, 2019 Published: July 23, 2019
We describe the extent to which comprehensive genomic profiling (CGP) results were used by oncologists to guide targeted therapy selection in a cohort of solid tumor patients tested as part of standard care at Roswell Park Comprehensive Cancer Center June 2016–June 2017, with adequate follow up through September 2018 (n = 620). Overall, 28.4% of CGP tests advised physicians about targeted therapy use supported by companion diagnostic or practice guideline evidence. Post-test targeted therapy uptake was highest for patients in active treatment at the time of order (86% versus 76% of treatment naïve patients), but also took longer to initiate (median 50 days versus 7 days for treatment naïve patients), with few patients (2.6%) receiving targeted agents prior to testing. 100% of patients with resistance variants did not receive targeted agents. Treatment naïve patients received immunotherapy as the most common alternative. When targeted therapy given off-label or in a trial was the best CGP option, (7%) of patients received it. Our data illustrate the appropriate and heterogeneous use of CGP by oncologists as a longitudinal treatment decision tool based on patient history and treatment needs, and that some patients may benefit from testing prior to initiation of other standard treatments.
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