Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany.
JCO Precis Oncol. 2021 Apr 22;5. doi: 10.1200/PO.20.00248. eCollection 2021.
CATCH (Comprehensive Assessment of clinical feaTures and biomarkers to identify patients with advanced or metastatic breast Cancer for marker driven trials in Humans) is a prospective precision oncology program that uses genomics and transcriptomics to guide therapeutic decisions in the clinical management of metastatic breast cancer. Herein, we report our single-center experience and results on the basis of the first 200 enrolled patients of an ongoing trial.
From June 2017 to March 2019, 200 patients who had either primary metastatic or progressive disease, with any number of previous treatment lines and at least one metastatic site accessible to biopsy, were enrolled. DNA and RNA from tumor tissue and corresponding blood-derived nontumor DNA were profiled using whole-genome and transcriptome sequencing. Identified actionable alterations were brought into clinical context in a multidisciplinary molecular tumor board (MTB) with the aim of prioritizing personalized treatment recommendations.
Among the first 200 enrolled patients, 128 (64%) were discussed in the MTB, of which 64 (50%) were subsequently treated according to MTB recommendation. Of 53 evaluable patients, 21 (40%) achieved either stable disease (n = 13, 25%) or partial response (n = 8, 15%). Furthermore, 16 (30%) of those patients showed improvement in progression-free survival of at least 30% while on MTB-recommended treatment compared with the progression-free survival of the previous treatment line.
The initial phase of this study demonstrates that precision oncology on the basis of whole-genome and RNA sequencing is feasible when applied in the clinical management of patients with metastatic breast cancer and provides clinical benefit to a substantial proportion of patients.
CATCH（全面评估临床特征和生物标志物以识别接受标志物驱动试验的晚期或转移性乳腺癌患者）是一项前瞻性精准肿瘤学计划，该计划使用基因组学和转录组学来指导转移性乳腺癌临床管理中的治疗决策。在此，我们根据正在进行的试验中前 200 名入组患者的情况报告了我们的单中心经验和结果。
从 2017 年 6 月至 2019 年 3 月，入组了 200 名患者，这些患者要么患有原发性转移性疾病，要么患有进展性疾病，之前有任意数量的治疗线数，并且至少有一个可进行活检的转移性部位。使用全基因组和转录组测序对肿瘤组织和相应的血液衍生非肿瘤 DNA 进行 DNA 和 RNA 分析。在多学科分子肿瘤委员会（MTB）中，将确定的可操作改变置于临床背景下，目的是确定个性化治疗建议的优先级。
在入组的前 200 名患者中，有 128 名（64%）在 MTB 中进行了讨论，其中 64 名（50%）根据 MTB 建议进行了后续治疗。在 53 名可评估的患者中，21 名（40%）患者实现了疾病稳定（n=13，25%）或部分缓解（n=8，15%）。此外，与之前的治疗线相比，在接受 MTB 推荐的治疗时，有 16 名（30%）患者的无进展生存期至少提高了 30%。
该研究的初始阶段表明，基于全基因组和 RNA 测序的精准肿瘤学在转移性乳腺癌患者的临床管理中是可行的，并为相当一部分患者提供了临床获益。
