Dana-Farber Cancer Study Shows Value of the Molecular Tumor Panel

Intestinal tumor, artwork
Photo credit: JUAN GARTNER/Getty Images

The Molecular Oncology Council at the Dana-Farber Cancer Institute (DFCI) provided treatment guidelines for more than 500 patients with gastrointestinal tumors over a six-month period. With 80% of patients matching appropriate trials and additional testing recommended for 42%. Overall, the board has reviewed the test results of more than 2,700 patients so far.

The team’s findings, reported this month in JCO Precision OncologyAnd We suggest that the DFCI program can serve as a model for other cancer centers.

“Our results show that precision medicine can be integrated into routine cancer care through a multidisciplinary oncology panel, and that this program is scalable and sustainable in a center like ours, which has a large patient population,” said the study’s senior author, Marius Giannakis of Dana Farber, PhD. in Medicine, Ph.D.

Tumor panels are becoming more prevalent with the advancement of precision oncology. This DFCI program consisted of a multidisciplinary team that was assisting gastrointestinal (GI) cancer physicians by reviewing test results and making timely recommendations on treatment options. Cancers of the gastrointestinal tract that included tumors of the bile duct, esophagus, colon and rectum, and pancreas were evaluated.

Called GI TARGET (To Assist in Therapy in Relation to the Genetic Evaluation of Tumors), the program includes a team of gastrointestinal oncologists, pathologists, genomic scientists, and research coordinators. The board reviews testing for genetic abnormalities in patients’ gastrointestinal tumors and finds clinical trials for drugs (or available off-label therapies) that target those abnormalities.

Giannakis said that comprehensive tumor profiling Inside Precision Medicine It is performed for all Dana-Farber patients and other molecular tumor panels have also been launched. “To make the best decisions for patients, oncologists ideally need to understand the complexities of genome testing and a working knowledge of cancer genetics — which can be difficult to apply in a busy clinic,” he said. “Our program relieves oncologists from some of this burden through the assistance of a team of experts.”

Giannakis said Inside Precision Medicine The main factors influence the value of such a panel: “First, is the presence and prevalence of molecular ‘driver’ changes in a given malignancy that are captured by current tumor profiling techniques. The second is whether these modifications are actionable based on targeted therapeutic approaches and clinical trials. and based on available immunity.”

The research results refer to 506 patients with gastrointestinal cancer who were treated at Dana-Farber Brigham Cancer Center between January and June 2019. Most of the tumor samples were analyzed by OncoPanel, a test that can detect more than 450 genetic abnormalities in the tissues. OncoPanel was created based on Profile, a database of cancer-causing genetic abnormalities that the center says is one of the largest in the world.

The results were reviewed by the Oncology Council, which also used MatchMiner, a computational platform developed at Dana-Farber, to match patients to targeted treatment trials based on genetic changes in patients’ tumors. The board met weekly and the average time between examination of tumor samples and issuance of treatment recommendations was eight days.

The knowledge base used by the board is updated in real time. For reports generated in the past, which may need updated annotation and new empirical matching, there may be a further interdisciplinary discussion. In some cases, GI TARGET has recommended repeat sampling and cancer testing to account for progression and/or tumor heterogeneity.

“We hope that the GI TARGET program and our experience will be useful for developing similar programs across the country and in multiple settings, including non-academic ones,” said Giannakis. “As next steps at Dana-Farber Cancer Institute, we are considering incorporating additional assays, such as immunogenicity-based profiling and paradigms.” preclinical.”

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