Panel-guided personalized medicine in metastatic breast and gynecological cancer: First experiences at the CCC Munich and clinically relevant changes over time

Sultova, Elena; Cb, Westphalen; Jung, Andreas; Kirchner, Thomas; Mayr, Doris; Rudelius, Martina; Ormanns, Steffen; Kumbrink, Jörg; Heinemann, Volker; Metzeler, Klaus H.; Pa, Greif; Trillsch, Fabian; Mahner, Sven; Harbeck, Nadia; Würstlein, Rachel

doi:10.1055/s-0040-1718188

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“…In our clinical center, we managed to evaluate this trend over the past two and half years. Comparing the results of the presented study with those of our first study where we presented results of the first 100 patients with mBC or gynecologic malignancies, we have observed an improvement in the therapy implementation rates (16% in the presented study vs. 12.5% in the previous study), in the number of recommendations given (49% vs. 42%), and in the number of mutations found (53% vs. 48%) [ 59 ]. In addition, the number of technical problems occurring in the molecular diagnostics was significantly lower in the presented trial as compared to our earlier experiences (11% vs. 17% in our last presented study).…”

Section: Discussionmentioning

confidence: 55%

Implementation of Precision Oncology for Patients with Metastatic Breast Cancer in an Interdisciplinary MTB Setting

Sultova

Westphalen

Jung³

et al. 2021

Diagnostics

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The advent of molecular diagnostics and the rising number of targeted therapies have facilitated development of precision oncology for cancer patients. In order to demonstrate its impact for patients with metastatic breast cancer (mBC), we initiated a Molecular Tumor Board (MTB) to provide treatment recommendations for mBC patients who had disease progression under standard treatment. NGS (next generation sequencing) was carried out using the Oncomine multi-gene panel testing system (Ion Torrent). The MTB reviewed molecular diagnostics’ results, relevant tumor characteristics, patient’s course of disease and made personalized treatment and/or diagnostic recommendations for each patient. From May 2017 to December 2019, 100 mBC patients were discussed by the local MTB. A total 72% of the mBC tumors had at least one molecular alteration (median 2 per case, range: 1 to 6). The most frequent genetic changes were found in the following genes: PIK3CA (19%) and TP53 (17%). The MTB rated 53% of these alterations as actionable and treatment recommendations were made accordingly for 49 (49%) patients. Sixteen patients (16%) underwent the suggested therapy. Nine out of sixteen patients (56%; 9% of all) experienced a clinical benefit with a progression-free survival ratio ≥ 1.3. Personalized targeted therapy recommendations resulting from MTB case discussions could provide substantial benefits for patients with mBC and should be implemented for all suitable patients.

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Section: Discussionmentioning

confidence: 55%