Basse Clémence, Morel Claire, Alt Marie, Sablin Marie Paule, Franck Coralie, Pierron Gaëlle, Callens Céline, Melaabi Samia, Masliah-Planchon Julien, Bataillon Guillaume, Gardrat Sophie, Lavigne Marion, Bonsang Benjamin, Vaflard Pauline, Pons Tostivint Elvire, Dubot Coraline, Loirat Delphine, Marous Miguelle, Geiss Romain, Clément Nathalie, Schleiermacher Gudrun, Kamoun Choumouss, Girard Elodie, Ardin Maude, Benoist Camille, Bernard Virginie, Mariani Odette, Rouzier Roman, Tresca Patricia, Servois Vincent, Vincent-Salomon Anne, Bieche Ivan, Le Tourneau Christophe, Kamal Maud
Department of Drug Development and Innovation, Institut Curie, Paris, France.
Department of Biopathology, Institut Curie, PSL Research University, Paris, France.
ESMO Open. 2018 Apr 6;3(3):e000339. doi: 10.1136/esmoopen-2018-000339. eCollection 2018.
High throughput molecular screening techniques allow the identification of multiple molecular alterations, some of which are actionable and can be targeted by molecularly targeted agents (MTA). We aimed at evaluating the relevance of using this approach in the frame of Institut Curie Molecular Tumor Board (MTB) to guide patients with cancer to clinical trials with MTAs.
We included all patients presented at Institut Curie MTB from 4 October 2014 to 31 October 2017. The following information was extracted from the chart: decision to perform tumour profiling, types of molecular analyses, samples used, molecular alterations identified and those which are actionable, and inclusion in a clinical trial with matched MTA.
736 patients were presented at the MTB. Molecular analyses were performed in 442 patients (60%). Techniques used included next-generation sequencing, comparative genomic hybridisation array and/or other techniques including immunohistochemistry in 78%, 51% and 58% of patients, respectively. Analyses were performed on a fresh frozen biopsy in 91 patients (21%), on archival tissue (fixed or frozen) in 326 patients (74%) and on both archival and fresh frozen biopsy in 25 patients (6%). At least one molecular alteration was identified in 280 analysed patients (63%). An actionable molecular alteration was identified in 207 analysed patients (47%). Forty-five analysed patients (10%) were enrolled in a clinical trial with matched MTA and 29 additional patients were oriented and included in a clinical trial based on a molecular alteration identified prior to the MTB analysis. Median time between date of specimen reception and molecular results was 28 days (range: 5-168).
The implementation of an MTB at Institut Curie enabled the inclusion of 10% of patients into a clinical trial with matched therapy.
高通量分子筛查技术可识别多种分子改变,其中一些改变是可采取行动的,并且可以被分子靶向药物(MTA)靶向。我们旨在评估在居里研究所分子肿瘤委员会(MTB)框架内使用这种方法来指导癌症患者参加MTA临床试验的相关性。
我们纳入了2014年10月4日至2017年10月31日在居里研究所MTB就诊的所有患者。从病历中提取了以下信息:进行肿瘤分析的决定、分子分析的类型、使用的样本、鉴定出的分子改变以及可采取行动的改变,以及参加匹配MTA的临床试验情况。
736名患者在MTB就诊。442名患者(60%)进行了分子分析。使用的技术包括二代测序、比较基因组杂交阵列和/或其他技术,分别有78%、51%和58%的患者使用。91名患者(21%)对新鲜冷冻活检样本进行了分析,326名患者(74%)对存档组织(固定或冷冻)进行了分析,25名患者(6%)对存档和新鲜冷冻活检样本都进行了分析。在280名接受分析的患者(63%)中至少鉴定出一种分子改变。在207名接受分析的患者(47%)中鉴定出可采取行动的分子改变。45名接受分析的患者(10%)参加了匹配MTA的临床试验,另外29名患者根据MTB分析之前鉴定出的分子改变被引导并纳入了临床试验。样本接收日期与分子结果之间的中位时间为28天(范围:5 - 168天)。
居里研究所实施MTB使得10%的患者能够参加匹配治疗的临床试验。