Study Uses Comprehensive Genomic Tumor Testing to Match Lung Cancer Patients With Targeted Therapies
In a recent study by the Lung Cancer Mutation Consortium (LCMC), investigators incorporated tumor genotyping into therapeutic decision-making for patients with lung adenocarcinomas. An oncogenic driver was detected in 64% of tumors from patients in this study. According to data from this study published in the Journal of the American Medical Association, matching drugs to the oncogenic drivers identified through this program may improve patients’ survival.
“This has transformed the way we treat people with lung cancers,” said lead coauthor Mark G. Kris, MD, the Ruane Chair in Thoracic Oncology at Memorial Sloan Kettering Cancer Center. “It used to be that when lung cancers were diagnosed solely by a visual microscopic examination of tumor tissues by a pathologist, every patient received the same intravenous chemotherapy. But now, we are personalizing the care of these individuals by finding the genetic alterations in the tumor tissues that drive their cancers and giving medicines that specifically counteract the cancerous effects of those genes.”
Study Details
Dr. Kris and colleagues used multiplex genetic testing to analyze DNA from tumor tissues and perform other techniques to detect the presence of 10 driver oncogenes in more than 1,000 patients from 14 different hospitals across the United States. The study included patients with stage IV or recurrent adenocarcinomas of the lung.
Tumors from 1,007 patients were tested for at least one gene; 733 patients had tumors fully genotyped and were tested for 10 genes. Among the latter group, oncogenic drivers were identified in 64% of the tumor specimens. Doctors were able to recommend a targeted drug therapy from either the pharmacy or a clinical trial in 28% of those cases.
“When we find these specific genetic changes, the doctor can choose drugs and clinical trials specifically targeting those oncogenic drivers. When that happens, the chance of shrinkage is much higher than with standard chemotherapies. The side effects are much less because the cancer cells are much more dependent on these oncogenes than normal cells,” said Dr. Kris.
Patients with oncogenic drivers who received targeted drug treatment had a median survival of about 3.5 years, patients with oncogenic drivers who did not receive targeted therapies had a median survival of about 2.4 years, and patients with no identified oncogenic driver had a median survival of 2.1 years.
Better Outcomes With Appropriate Targeted Therapy
Although individuals with oncogenic drivers who received targeted drug treatment lived longer, randomized clinical trials are required to determine if selecting targeted therapy based on oncogenic drivers improves survival.
“This study showed that we can routinely and simultaneously test for the most important genetic changes in the tumors of patients with lung cancers,” said Marc Ladanyi, MD, Memorial Sloan Kettering’s Chief of Molecular Diagnostics and coinvestigator on the study. “This information can guide the selection of targeted therapies to treat lung cancer patients because a key finding of the study suggested better outcomes for patients whose tumors had oncogenic drivers and who were given the appropriate targeted treatment.”
Dr. Kris is the corresponding author for the JAMA article.
The study was supported by grant from the National Institutes of Health, National Cancer Institute. For full disclosures of the study authors, visit jama.jamanetwork.com.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
