CLN Article

Routine Genomic Testing in Advanced Cancer is Practical, but Challenges Remain in Bringing Benefits to All Patients

The Sample: August 2017

Genomic testing in patients with advanced refractory cancer is feasible, but only benefits a few right now through molecular targeted therapies (MTT) that lead to extended survival, new research indicates. An ongoing trial based in France and presented in June as an abstract (LBA 100) at the American Society of Clinical Oncology annual meeting shows the promise of genomics to transform cancer care. 

The researchers performed targeted exon sequencing for 69 cancer-related genes and whole genome array comparative genomic hybridization on tumor samples from 1,944 patients with colorectal, gynecological, breast, head and neck, carcinomas, sarcomas, or brain tumors. A multidisciplinary tumor board analyzed this genomic data and recommended MTT.

Overall, 52% of patients were found to have actionable alterations, and the tumor board recommended MTT in 676 patients. Yet only 143 actually received these MTTs. Those who did not receive MTT typically were unable to because of rapid disease progression, not meeting clinical trial eligibility, or difficulty in obtaining off-label commercial medications.