Loading
Sequencing 860 patients with advanced lung adenocarcinoma as they arrived in clinic answered a question nobody had measured: how many of them actually get a treatment because of the test. Just over a third did.
Eight hundred and sixty patients with metastatic lung adenocarcinoma were analysed prospectively for mutations in more than 300 cancer-associated genes. Potentially actionable genetic events were stratified into four levels by the published evidence that the alteration confers sensitivity to a standard or investigational therapy. Overall, 319 of 860 patients, 37.1%, received a matched therapy guided by the molecular profile. Excluding alterations already associated with standard-of-care therapy, 69 of 478 patients, 14.4%, received matched therapy, with clinical benefit in 52% of them. Use of matched therapy was strongly influenced by the level of pre-existing evidence that the alteration predicts drug response. Analysis of genes mutated significantly more often in tumours without a known actionable alteration nominated STK11 and KEAP1 as possible targetable mitogenic drivers.
It is the honest accounting of precision oncology in the disease where it works best: broad sequencing changes treatment for about one patient in three, and the bottleneck is evidence rather than detection.
Shares ROS1, RET, Next-generation sequencing (NGS), MET.
Shares ROS1, RET, Next-generation sequencing (NGS), MET.
Shares Non-small cell lung cancer (KEGG map), Driver mutation, Next-generation sequencing (NGS), MET.
Shares Gregory J. Riely, STK11 / KEAP1 co-mutations, KEAP1, STK11.
Shares Gregory J. Riely, STK11 / KEAP1 co-mutations, KEAP1, STK11.
Shares ROS1, RET, Non-small cell lung cancer (KEGG map), Next-generation sequencing (NGS).
Shares KEAP1, STK11, Non-small cell lung cancer (KEGG map), Driver mutation.