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Tumor molecular profiling in the treatment of refractory cancers
Birendra KC, Muhammad Zubair Afzal, Andrew Sochaki, Katherine A. Wentland, Rubens Chang, Sudhir Singh and Timothy O’Rourke

Introduction: Molecular profiling (MP) has been used as a technique to identify treatment regimens for individual patient’s cancer. The results of MP has been used to guide targeted therapy specific to each patient’s tumor that resulted in a longer progression free survival (PFS) compared to the last conventional treatment. This study aims to provide further data to delineate the PFS of patients who get treated with targeted therapy based on MP.

Methods: A retrospective chart review was performed. The patients were greater than 18 years of age refractory to at least one standard treatment and enrolled in the study: “A Clinical Data Registry Study of Patients with Advanced Refractory Cancers Electing OncInsights™ as a Method to Support Physician Choice of Drug Therapy”. The location is a West Michigan Hematology-Oncology private practice during the period of 07/2010-02/2013. We considered the molecular profiled treatment regimen a success if the PFS ratio was >1.3.

Results: 18 patients were included in the study. 55% were male and 45% were female with median age of 57.67 +/-12.02 at the time of diagnosis. 4/18 (22%) patients achieved a PFS ratio >1.3. The patients with a PFS ratio>1.3 included GIST (imatinib->sunitinib); angiosarcoma (docetaxel->sorafenib, pravastatin); thymoma (paclitaxel->desatinib); and angiosarcoma (gemcitabine->sunitinib).

Conclusion: This study demonstrates the potential value of molecular profiling in patients refractory to prior chemotherapeutic agents in a community setting. Continued work on rapid implementation of molecular profiling earlier in the care of oncology patients continues to be a future goal.

Keywords: molecular profiling, refractory tumors, solid tumors.

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