domingo, 28 de julio de 2019

Clinical utility of FoundationOne tissue molecular profiling in men with metastatic prostate cancer. - PubMed - NCBI

2019 Jul 18. pii: S1078-1439(19)30244-3. doi: 10.1016/j.urolonc.2019.06.015. [Epub ahead of print]

Clinical utility of FoundationOne tissue molecular profiling in men with metastatic prostate cancer.

Zhu J1, Tucker M1, Marin D2, Gupta RT3, Healy P4, Humeniuk M5, Jarvis C1, Zhang T6, McNamara M6, George DJ6, Wu Y4, Lisi S7, Armstrong AJ8.

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Abstract

PURPOSE:

Targeted inhibitors and immunotherapy have entered the treatment landscape of metastatic prostate cancer. Genomic testing may uncover which patients benefit most from these therapies. We report the clinical utility and benefits of FoundationOne testing in men with advanced prostate cancer.

PATIENTS AND METHODS:

We retrospectively identified all men with prostate cancer who received tissue FoundationOne testing at our institution between January 2010 and April 2017. Genomic alterations, treatment selection based on FoundationOne results, and clinical outcomes including response and duration of therapy following matched targeted therapy were analyzed.

RESULTS:

A total of 77 men with metastatic prostate cancer were referred for FoundationOne testing; 59 (77%) had sufficient tumor tissue for testing. Of these, 22% (17/77) of men had a targetable mutation and 9% (7/77) of men received matched off-label targeted therapy. Overall, 5% (4/77) of patients derived clinical benefit. One patient with a BRCA2 loss had a complete response on olaparib (>27 months) and 3 patients (ATM substitution, PALB2 frameshift, CDK12 frameshift) had stable disease with olaparib (10.3, 18.7, and 7.8 months, respectively). Three patients (BRCA2 frameshift, PDL1 + PDL2 amplification, PMS2 missense) had progressive disease despite targeted therapy.

CONCLUSIONS:

Tissue genomic testing can uncover patients who may benefit from targeted therapies such as poly(adenosine diphosphate-ribose) polymerase inhibitors or immunotherapy. In our limited single institution study, genomic testing led to clinical benefit in 5% of patients. Combined germline and circulating tumor DNA testing may be helpful to identify additional patients suitable for matched genomic therapies.