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. 2017 Oct;72(10):588-594.
doi: 10.6061/clinics/2017(10)01.

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

Gustavo S Fernandes  1 , Daniel F Marques  1 , Daniel M Girardi  2 , Maria Ignez F Braghiroli  1   2 , Renata A Coudry  1 , Sibele I Meireles  1 , Artur Katz  1 , Paulo M Hoff  1   2
Affiliations

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

Gustavo S Fernandes et al. Clinics (Sao Paulo). 2017 Oct.

Abstract

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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Conflict of interest statement

No potential conflict of interest was reported.

Figures

Figure 1
Figure 1
A = Progression-free survival for patients with matched therapy based on the results of the FM-CGP. B = Overall survival for patients with matched therapy based on the results of the FM-CGP.
Figure 2
Figure 2
A = Progression-free survival for patients with targeted therapy against HER2 versus any other targeted therapy. B = Overall survival for patients with targeted therapy against HER2 versus any other targeted therapy.
See this image and copyright information in PMC

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