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. 2023 Jun 28;15(13):3395.
doi: 10.3390/cancers15133395.

The Challenges and Opportunities of the Implementation of Comprehensive Genomic Profiling in Everyday Clinical Practice with Non-Small Cell Lung Cancer: National Results from Croatia

Dora Čerina  1   2 , Kristina Krpina  3 , Marko Jakopović  3   4 , Natalija Dedić Plavetić  4   5 , Fran Seiwerth  3 , Snježana Tomić  2   6 , Jasna Radić  7 , Ingrid Belac Lovasić  8 , Ivana Canjko  9 , Marijo Boban  1   2 , Miroslav Samaržija  3   4 , Eduard Vrdoljak  1   2
Affiliations

The Challenges and Opportunities of the Implementation of Comprehensive Genomic Profiling in Everyday Clinical Practice with Non-Small Cell Lung Cancer: National Results from Croatia

Dora Čerina et al. Cancers (Basel). .

Abstract

Non-small cell lung cancer (NSCLC) has become the best example of precision oncology's impact on outcomes in everyday clinical practice, significantly changing the expectations of all stakeholders, including medical professionals, society, and most importantly, patients. Consequently, the implementation of the precision oncology concept in medical systems, in order to achieve optimal and proven curative effects in NSCLC, is imperative. In this study, we investigated the development, challenges, and results associated with the implementation of precision oncology in NSCLC on a national level in Croatia. We conducted a multicenter, retrospective, cross-sectional analysis on the total population of Croatian patients with metastatic lung cancer, on whose tumors specimen comprehensive genomic profiling (CGP) testing was performed during 2020 and 2021. A total of 48 patients were included in the study. CGP revealed clinically relevant genomic alterations (CRGA) in 37 patients (79%), with a median of 2 (IQR 1-3) CRGA per patient. From the panel of recommended tests, KRAS, MET, and EGFR were the most common alterations, detected in 16 (34%), 5 (11%), and 3 (6%) patients, respectively. CGP revealed additional targetable mutations in 29 (60%) patients who would not have been tested (and consequently, whose mutations would not have been detected) according to the existing everyday standard of practice in Croatia. The tumor mutational burden was reported as high (≥10 Muts/Mb) in 19 patients (40%). CGP analysis reported some kind of targeted therapy for 34 patients (72%). CGP revealed other potentially targetable mutations, and it also determined TMB to be high in a significant number of patients. In conclusion, when possible, CGP should be used as an upfront backbone diagnostic and treatment-oriented work-up in patients with NSCLC.

Keywords: NSCLC; comprehensive genomic profiling; precision medicine.

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Conflict of interest statement

Dora Čerina: Speaker fees: Roche; Kristina Krpina: speaker’s fees and traveler’s grants from Roche and MSD; Marko Jakopović: speaker’s fees, traveler’s grants, consultancy from Roche, MSD, Pfizer, Takeda, Boehringer Ingelheim, Amgen, BMS, Astra Zeneca, Johnson & Johnson; Natalija Dedić Plavetić: Speaker’s fee and consulting: Roche. Novartis, MSD; Pfizer, Astra Zeneca, Elli Lilly, Swixx; Support for clinical trials: Roche, Novartis; Fran Seiwerth: speaker’s fees and traveler’s grants from Roche, Takeda, Boehringer Ingelheim; Snježana Tomić: speaker’s fees and consulting: Roche, Astra Zeneca, Amgen, MSD, Johnson & Johnson, Novartis; Jasna Radić: speaker’s fees and consulting: Abbott, Amgen, Astra Zeneca, BMS, Boehringer Ingelheim, Merck, MSD, Pfizer, Roche, Servier, Takeda; Ingrid Belac Lovasić: speaker’s fees and consulting: Amgen, Astellas, Astra Zeneca, BMS, Merck, Novartis, Pfizer, Roche, Sanofi, MSD; Ivana Canjko: speaker’s fees: Roche, MSD, Abbot, Takeda, Stada, Alvogen, Boehringer Inn, and AstraZeneca; Marijo Boban: speaker’s fees and consulting: Abbott, Amgen, AstraZeneca, BMS, Boehringer Ingelheim, Merck, MSD, Pfizer, Roche, Servier, Takeda; Miroslav Samaržija: speaker’s fees, traveler’s grants, consultancy from Roche, MSD, Pfizer, Takeda, Boehringer Ingelheim, Amgen, BMS, Astra Zeneca, Johnson & Johnson, Berlin Chemie; Eduard Vrdoljak: Support for clinical trials and scientific projects: Pfizer, Roche, BMS, and AZ; speaker’s fees and consulting: Amgen, Astellas, Astra Zeneca, Boehringer Ingelheim, Johnson & Johnson, Novartis, Pharmaswiss, Pfizer, Roche, Sanofi, MSD, and Merck.

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