Introduction/Background Treating late-stage cancer according to its genetic mutations is the goal of precision medicine tumor boards (PMTB) that gain importance along with the advances and cost reduction in next generation sequencing (NGS) techniques. Still, their clinical applicability differs according to tumor origin and has been evaluated in detail for Ovarian Cancer patients within this analysis
Methodology All ovarian cancer patients whose molecular profile was discussed in a PMTB at the Medical University of Vienna, Austria, from 2015 to 2018 were included in this retrospective analysis (n=33). Not only the NGS results, immunohistochemical (IHC) profiles and respective recommended targeted treatments were determined, but especially the patient characteristics related to actual treatment implementation, duration and outcome.
Results In 82% at least one mutation, deletion or amplification could be detected. The most frequently altered genes were p53 and PIK3CA, followed by BRCA1, BRCA2, and KRAS. A total of 73% had potentially actionable gene alterations and/or a respective IHC expression profile resulting in a treatment recommendation. Thereof, 7 patients (29%; with 2 to 4 previous lines of standard treatment) received the respective therapy. In 71% the allocated treatment was not administered due to: poor performance status (patients were referred to palliative/hospice care, n=9; or died immediately after the PMTB, n=2); patients received an alternative therapy (n=4); patients were further treated in another clinic (n=2).
Conclusion Even though a personalized treatment recommendation can be derived frequently, the current treatment implementation in clinical practice remains limited especially due to the poor general condition of ovarian cancer patients after exploitation of standard treatment. However, as each tumor is unique, the obtained molecular genetic data and related clinical characteristics are valuable and will feed the future development of pathway-based drug discovery.
Disclosure SA: travelling expenses: Roche, Pharma Mar, Amgen, lecture fee: Roche RS: travelling expenses: Roche, Pharma Mar, Amgen GP: speakers fee and/or advisory boards: Bayer, Celgene, Servier, Halozyme, Taiho, Roche, Merck, Sanofi, Amgen, Lilly, BMS, MSD CG, TG none to declare KH: speakers fee and/or advisory boards: Astellas, Pfizer, AMS, Takeda, Johnson & Johnson SP Consultant AstraZeneca, Celgene, MSD, PharmaMar, Roche,Roche Diagnostics, Meda Pharma, Tesaro, Vifor Pharma, outside the submitted work. CG Consultant: AstraZeneca, Celgene, MSD, PharmaMar, Roche, Tesaro, Vifor Pharma Speaker: Amgen, AstraZeneca, MSD, PharmaMar, Roche, Tesaro Direct research funding: Meda Pharma, Roche Diagnostics AR Research grants: Roche Honoraria as a speaker and for advisory boards: Amgen, Astra Zeneca, MSD, Pharma Mar, Roche, Tesaro, Vifor Pharma Travel expenses: Amgen, Astra Zeneca, Pharma Mar, Roche, Tesaro.
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