lunes, 19 de agosto de 2019

Oncologist uptake of comprehensive genomic profile guided targeted therapy. - PubMed - NCBI

2019 Jul 23;10(45):4616-4629. doi: 10.18632/oncotarget.27047. eCollection 2019 Jul 23.

Oncologist uptake of comprehensive genomic profile guided targeted therapy.

Nesline MK1, DePietro P1, Dy GK2, Early A2, Papanicolau-Sengos A1, Conroy JM1,3, Lenzo FL1, Glenn ST1, Chen H2, Grand'Maison A2, Boland P2, Ernstoff MS2, Puzanov I2, Edge S4, Akers S2, Opyrchal M2, Chatta G2, Odunsi K2, Frederick P5, Lele S5, Gardner M1, Morrison C1,6,7.

Author information

1: OmniSeq Inc., Buffalo, NY 14203, USA.
2: Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
3: Center for Personalized Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
4: Department of Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
5: Division of Gynecologic Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
6: Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.
7: Cancer Genetics and Genomics, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.

Abstract

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.