Introduction/Background Next Generation Sequencing (NGS) technology enables for the simultaneous study of multiple gene alterations in the patient‘s tumor with potential implications for genetic risk assessment, prognosis, and therapy.
Methodology CUN opened a new hospital in Madrid in January 2018. During the first year, new patients (pts) with EOC at both CUN were offered to perform a NGS-based tumor testing. Local test consisted in Oncomine Comprehensive Assay (161 gene panel, ThermoFisher Scientific) and external test in Foundation Medicine (Foundation Medicine, Cambridge, MA). This is a descriptive analysis of the rate of implementation, the molecular alterations found, and the therapeutic implications derived.
Results 104 new pts were evaluated from January 1st until December 31st. 5 (4.80%) LOGSOC, 81 (77.89%) HGSOC, 11 (10.58%) CCC, 6 (5.77%) Endometrioid, 1 (0.96%) Mucinous. 44 pts with primary disease and 60 pts with recurrent disease. All but two patients were tested with Oncomine with a median turn-around time of 14 days.
Table shows the rate of patients tested according to histology and context of disease.
Subtype N Tested in First Line Tested in recurrence.
LGSOC 5 2/2 (100%) 1/3 (33.33%).
HGSOC 81 17/34 (50%) 14/47 (29,78%).
Endometrioid 6 1/2 (50%) 0/4 (0%).
CCC 11 3/6 (50%) 1/5 (20%).
Mucinous 1 0/0 0/1 (0%).
TOTAL 104 23/44 (52.57%) 16/60 (26.67%).
sBRCA mutation was detected in 6/23 primary diagnosis (26.1%) and 2 pts (both gBRCAwt) received olaparib maintenance after SOLO-1 publication. In the recurrent setting, 5/16 pts (31.25%) had at least one actionable mutation with available matched therapy and 3 pts received matched therapy (18.76%). Non-BRCA genes associated to hereditary EOC were detected in 4 pts.
Conclusion Integration of a precision medicine program with NGS tumor testing was feasible in routine practice in a private university hospital. This is an ongoing program and the rate of tumor testing should improve in subsequent years.
Disclosure Advisory for Roche and Tesaro.
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