TY - JOUR
T1 - The clinical impact of using complex molecular profiling strategies in routine oncology practice
AU - Laes, Jean François
AU - Aftimos, Philippe
AU - Barthelemy, Philippe
AU - Bellmunt, Joaquim
AU - Berchem, Guy
AU - Camps, Carlos
AU - de las Peñas, Ramón
AU - Finzel, Ana
AU - García-Foncillas, Jesús
AU - Hervonen, Petteri
AU - Wahid, Ibrahim
AU - Joensuu, Timo
AU - Kathan, Louis
AU - Kong, Anthony
AU - Mackay, James
AU - Mikropoulos, Christos
AU - Mokbel, Kefah
AU - Mouysset, Jean Loup
AU - Odarchenko, Sergey
AU - Perren, Timothy J.
AU - Pienaar, Rika
AU - Regonesi, Carlos
AU - Alkhayyat, Shadi Salem
AU - El Kinge, Abdul Rahman
AU - Abulkhair, Omalkhair
AU - Galal, Khaled Morsi
AU - Ghanem, Hady
AU - El Karak, Fadi
AU - Garcia, Angel
AU - Ghitti, Gregori
AU - Sadik, Helen
N1 - Publisher Copyright:
© Laes et al.
PY - 2018/4/17
Y1 - 2018/4/17
N2 - Molecular profiling and functional assessment of signalling pathways of advanced solid tumours are becoming increasingly available. However, their clinical utility in guiding patients' treatment remains unknown. Here, we assessed whether molecular profiling helps physicians in therapeutic decision making by analysing the molecular profiles of 1057 advanced cancer patient samples after failing at least one standard of care treatment using a combination of next-generation sequencing (NGS), immunohistochemistry (IHC) and other specific tests. The resulting information was interpreted and personalized treatments for each patient were suggested. Our data showed that NGS alone provided the oncologist with useful information in 10-50% of cases (depending on cancer type), whereas the addition of IHC/other tests increased extensively the usefulness of the information provided. Using internet surveys, we investigated how therapy recommendations influenced treatment choice of the oncologist. For patients who were still alive after the provision of the molecular information (76.8%), 60.4% of their oncologists followed report recommendations. Most treatment decisions (93.4%) were made based on the combination of NGS and IHC/other tests, and an approved drug- rather than clinical trial enrolment- was the main treatment choice. Most common reasons given by physicians to explain the non-adherence to recommendations were drug availability and cost, which remain barriers to personalised precision medicine. Finally, we observed that 27% of patients treated with the suggested therapies had an overall survival > 12 months. Our study demonstrates that the combination of NGS and IHC/other tests provides the most useful information in aiding treatment decisions by oncologists in routine clinical practice.
AB - Molecular profiling and functional assessment of signalling pathways of advanced solid tumours are becoming increasingly available. However, their clinical utility in guiding patients' treatment remains unknown. Here, we assessed whether molecular profiling helps physicians in therapeutic decision making by analysing the molecular profiles of 1057 advanced cancer patient samples after failing at least one standard of care treatment using a combination of next-generation sequencing (NGS), immunohistochemistry (IHC) and other specific tests. The resulting information was interpreted and personalized treatments for each patient were suggested. Our data showed that NGS alone provided the oncologist with useful information in 10-50% of cases (depending on cancer type), whereas the addition of IHC/other tests increased extensively the usefulness of the information provided. Using internet surveys, we investigated how therapy recommendations influenced treatment choice of the oncologist. For patients who were still alive after the provision of the molecular information (76.8%), 60.4% of their oncologists followed report recommendations. Most treatment decisions (93.4%) were made based on the combination of NGS and IHC/other tests, and an approved drug- rather than clinical trial enrolment- was the main treatment choice. Most common reasons given by physicians to explain the non-adherence to recommendations were drug availability and cost, which remain barriers to personalised precision medicine. Finally, we observed that 27% of patients treated with the suggested therapies had an overall survival > 12 months. Our study demonstrates that the combination of NGS and IHC/other tests provides the most useful information in aiding treatment decisions by oncologists in routine clinical practice.
KW - Molecular profiling
KW - Next-generation sequencing
KW - Precision medicine
KW - Solid tumour
KW - Therapeutic decision making in oncology
UR - http://www.scopus.com/inward/record.url?scp=85045532618&partnerID=8YFLogxK
U2 - 10.18632/oncotarget.24757
DO - 10.18632/oncotarget.24757
M3 - Article
AN - SCOPUS:85045532618
SN - 1949-2553
VL - 9
SP - 20282
EP - 20293
JO - Oncotarget
JF - Oncotarget
IS - 29
ER -