Clinical benefit for clinical sequencing using cancer panel testing

Abstract

Background Clinical sequencing using a panel of genes has recently been applied worldwide for patients with refractory solid tumors, but the significance of clinical sequencing using gene panel testing remains uncertain. Here we sought to clarify the feasibility and utility of clinical sequencing in the treatment of refractory tumors at our hospital. Methods A total of 39 patients with advanced solid tumors treated at our hospital between 2018 and 2020 were enrolled in the clinical sequencing. Among them, we identified 36 patients whose tissue samples were of suitable quality for clinical sequencing, and we analyzed the genomic profiles of these tumors. Results Pathogenic alterations were detected in 28 (78%) of the 36 patients. The most common mutation was TP53 (55%), followed by KRAS (22%), and the highest frequency of gene amplification was ERBB2 (17%). Nine of the 36 patients were identified as candidates for novel molecular-targeted therapy based on their actionable gene alterations, but only one case ended up receiving novel targeted therapy following the genetic tests. Conclusions Our current results suggested that clinical sequencing might be useful for the detection of pathogenic alterations and the management of additional cancer treatment. However, molecular target based on actionable genomic alteration does not always bridge to subsequent therapy due to clinical deterioration, refusal for unapproved drug, and complexity of clinical trial access. Both improved optimal timing of clinical sequencing and a consensus about its off-label use might help patients receive greater benefit from clinical sequencing.

Clinical Significance of Multi-Cancer Genome Profiling: Data from a Single Hospital in Japan

“…Currently, multi-CGP testing is applied to patients with advanced solid tumors who fail to respond to standard therapies in Japan (13). Some reports indicate that cancer genome tests should be performed before first-line treatment (14)(15)(16). Our study indicated that multi-CGP testing may help in the early examination, which will increase opportunities for "precision cancer care" based on genetic variants because cancer gene profiling testing takes time to finalize reports.…”

Artificial Intelligence and Precision Medicine: A New Frontier for the Treatment of Brain Tumors

“…Gene expression arrays (used in melanoma classifications) [ 61 ], and next-generation sequencing (NGS) are helping physicians determine how patients will respond to a particular therapy. These arrays and NGS will advance gene profiling technology to develop patient-specific treatments [ 62 , 63 ]. PM is very effective in treating some types of brain tumors, such as glioblastoma [ 64 ], using photodynamic therapy (PDT) [ 65 ].…”