Next-generation Sequencing-based genomic profiling: Fostering innovation in cancer care?

OBJECTIVES: With the development of next-generation sequencing (NGS) technologies, DNA sequencing has been increasingly utilized in clinical practice. Our goal was to investigate the impact of genomic evaluation on treatment decisions for heavily pretreated patients with metastatic cancer. METHODS:...

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Main Authors: Gustavo S. Fernandes, Daniel F. Marques, Daniel M. Girardi, Maria Ignez F. Braghiroli, Renata A. Coudry, Sibele I. Meireles, Artur Katz, Paulo M. Hoff
Format: Article
Language:English
Published: Elsevier España
Series:Clinics
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322017001000588&lng=en&tlng=en
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author Gustavo S. Fernandes
Daniel F. Marques
Daniel M. Girardi
Maria Ignez F. Braghiroli
Renata A. Coudry
Sibele I. Meireles
Artur Katz
Paulo M. Hoff
author_facet Gustavo S. Fernandes
Daniel F. Marques
Daniel M. Girardi
Maria Ignez F. Braghiroli
Renata A. Coudry
Sibele I. Meireles
Artur Katz
Paulo M. Hoff
author_sort Gustavo S. Fernandes
collection DOAJ
description OBJECTIVES: With the development of next-generation sequencing (NGS) technologies, DNA sequencing has been increasingly utilized in clinical practice. Our goal was to investigate the impact of genomic evaluation on treatment decisions for heavily pretreated patients with metastatic cancer. METHODS: We analyzed metastatic cancer patients from a single institution whose cancers had progressed after all available standard-of-care therapies and whose tumors underwent next-generation sequencing analysis. We determined the percentage of patients who received any therapy directed by the test, and its efficacy. RESULTS: From July 2013 to December 2015, 185 consecutive patients were tested using a commercially available next-generation sequencing-based test, and 157 patients were eligible. Sixty-six patients (42.0%) were female, and 91 (58.0%) were male. The mean age at diagnosis was 52.2 years, and the mean number of pre-test lines of systemic treatment was 2.7. One hundred and seventy-seven patients (95.6%) had at least one identified gene alteration. Twenty-four patients (15.2%) underwent systemic treatment directed by the test result. Of these, one patient had a complete response, four (16.7%) had partial responses, two (8.3%) had stable disease, and 17 (70.8%) had disease progression as the best result. The median progression-free survival time with matched therapy was 1.6 months, and the median overall survival was 10 months. CONCLUSION: We identified a high prevalence of gene alterations using an next-generation sequencing test. Although some benefit was associated with the matched therapy, most of the patients had disease progression as the best response, indicating the limited biological potential and unclear clinical relevance of this practice.
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spelling doaj.art-112b02f54ea548fbbd24de7147338e532022-12-22T02:42:05ZengElsevier EspañaClinics1980-5322721058859410.6061/clinics/2017(10)01S1807-59322017001000588Next-generation Sequencing-based genomic profiling: Fostering innovation in cancer care?Gustavo S. FernandesDaniel F. MarquesDaniel M. GirardiMaria Ignez F. BraghiroliRenata A. CoudrySibele I. MeirelesArtur KatzPaulo M. HoffOBJECTIVES: With the development of next-generation sequencing (NGS) technologies, DNA sequencing has been increasingly utilized in clinical practice. Our goal was to investigate the impact of genomic evaluation on treatment decisions for heavily pretreated patients with metastatic cancer. METHODS: We analyzed metastatic cancer patients from a single institution whose cancers had progressed after all available standard-of-care therapies and whose tumors underwent next-generation sequencing analysis. We determined the percentage of patients who received any therapy directed by the test, and its efficacy. RESULTS: From July 2013 to December 2015, 185 consecutive patients were tested using a commercially available next-generation sequencing-based test, and 157 patients were eligible. Sixty-six patients (42.0%) were female, and 91 (58.0%) were male. The mean age at diagnosis was 52.2 years, and the mean number of pre-test lines of systemic treatment was 2.7. One hundred and seventy-seven patients (95.6%) had at least one identified gene alteration. Twenty-four patients (15.2%) underwent systemic treatment directed by the test result. Of these, one patient had a complete response, four (16.7%) had partial responses, two (8.3%) had stable disease, and 17 (70.8%) had disease progression as the best result. The median progression-free survival time with matched therapy was 1.6 months, and the median overall survival was 10 months. CONCLUSION: We identified a high prevalence of gene alterations using an next-generation sequencing test. Although some benefit was associated with the matched therapy, most of the patients had disease progression as the best response, indicating the limited biological potential and unclear clinical relevance of this practice.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322017001000588&lng=en&tlng=enMolecular ProfilingTargeted TherapyPrecisionRefractory
spellingShingle Gustavo S. Fernandes
Daniel F. Marques
Daniel M. Girardi
Maria Ignez F. Braghiroli
Renata A. Coudry
Sibele I. Meireles
Artur Katz
Paulo M. Hoff
Next-generation Sequencing-based genomic profiling: Fostering innovation in cancer care?
Clinics
Molecular Profiling
Targeted Therapy
Precision
Refractory
title Next-generation Sequencing-based genomic profiling: Fostering innovation in cancer care?
title_full Next-generation Sequencing-based genomic profiling: Fostering innovation in cancer care?
title_fullStr Next-generation Sequencing-based genomic profiling: Fostering innovation in cancer care?
title_full_unstemmed Next-generation Sequencing-based genomic profiling: Fostering innovation in cancer care?
title_short Next-generation Sequencing-based genomic profiling: Fostering innovation in cancer care?
title_sort next generation sequencing based genomic profiling fostering innovation in cancer care
topic Molecular Profiling
Targeted Therapy
Precision
Refractory
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322017001000588&lng=en&tlng=en
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