Precision Oncology: The UC San Diego Moores Cancer Center PREDICT Experience

Authors

Abstract

By profiling their patients' tumors, oncologists now have the option to use molecular results to match patients with drug(s) based on specific biomarkers. In this observational study, 347 patients with solid advanced cancers and next-generation sequencing (NGS) results were evaluated. Outcomes for patients who received a "matched" versus "unmatched" therapy following their NGS results were compared. Eighty-seven patients (25%) were treated with a "matched" therapy; 93 (26.8%) with an "unmatched" therapy. More patients in the matched group achieved [SD≥6 months/PR/CR] (34.5% versus 16.1%, (P≤0.020 multivariable or propensity score methods). Matched patients had a longer median PFS (4.0 versus 3.0 months, P=0.039 in Cox regression model). In analysis using PFS1 (PFS on the prior line of therapy) as a comparator to PFS after NGS, as expected, the unmatched group demonstrated a PFS2 significantly shorter than PFS1 (P=0.009); however, this shortening was not observed in the matched patients (P=0.595). Furthermore, 45.3% of the matched patients (24/53) had a PFS2/PFS1 ratio ≥1.3 compared to 19.3% of patients (11/57) in the unmatched group (P=0.004 univariable and P≥0.057 in multivariable/propensity score analysis). Patients with a "matching-score" (the number of matched drugs divided by the number of aberrations; unmatched patients had a score of zero) >0.2 had a median overall survival of 15.7 months compared to 10.6 months when their matching-score was ≤0.2, (P=0.040 in Cox regression model). Matched versus unmatched patients had higher rates of SD≥6 months/PR/CR and longer PFS, and improvement in OS correlated with a higher matching score in multivariable analysis.