advanced cancer

A recent study conducted by physicians at the Cancer Treatment Centres of America demonstrates that tumour gene profiling in community practice may largely benefit patients with advanced cancer.

Targeted drugs refer to a class of anti-cancer medications that are specifically matched to a patient with advanced cancer. Mutations in patients’ tumour genes can be detected through tumour gene profiling. With these results, clinicians can choose the targeted drug that will match the DNA alterations of the tumours. This is an innovative approach to individualizing cancer treatment.

Most patients with advanced cancer are treated in community practice

This approach is used in about 25% of people with advanced cancer treated at Comprehensive Cancer Care Network centres in the United States. Expanding the use of targeted drugs for the treatment of advanced cancer in community practice would allow for an increase in patient access. In fact, most patients with advanced cancer are treated in community practice. This innovative approach to advanced cancer treatment would have a great impact on patients treated in the community setting.

In this large-scale study, the researchers analysed tumour DNA from over 6000 patients with advanced cancer. The most common tumours that were studied came from patients with advanced breast, colorectal, lung, and gynecological cancers. The researchers identified genetic mutations in 94% of the samples tested; however, only 47% were regarded as clinically significant. Subsequent data revealed that 23% of patients were prescribed a genomically-matched treatment. These results were presented on October 20th at the European Society for Medical Oncology 2018 congress in Munich, Germany.

Targeted therapy is more costly

One of the pitfalls of this innovative approach to advanced cancer treatment is the cost of performing a genomic analysis of tumour cells. Patients with advanced cancer that are unresponsive to traditional anti-cancer medicines are targeted for tumour gene profiling. These patients must undergo a biopsy of their tumour to collect the cells to be analysed. The samples are transported to a laboratory for testing and results typically arrive in three weeks. Targeted therapy takes time before the specific drug is selected. In addition, a considerable amount of funds are needed to provide genomic analyses for the vast number of patients with advanced cancer.

Several improvements still needed

This approach to treat cancer has yet to be standardized. Variability in matching tumour genetic profiling to targeted therapy has been detected in clinical trials. A simplified standardized approach is necessary for the implementation of this approach to treating advanced cancer in the community setting.

Targeted therapies are gaining in popularity. They allow for more effective treatment of many conditions such as advanced cancer. Several improvements are required before a full implementation of this costly approach can occur in the community setting. Further studies are required to standardize and simplify the approach for use in community practice.

Written by Jessica Caporuscio, PharmD

References:

  1. European Society of Medical Oncology. Targeted drugs for advanced cancer move from specialist units to community setting. Press Release. 2018 oct 9. https://www.esmo.org/Press-Office/Press-Releases/Mutations-sequencing-cancer-Alvarez
  2. Alvarez RH, Moran A, Mein E, et al. Mutational landscape of metastatic cancers discovered from prospective clinical sequencing at community practice cancer program. [abstract]. ESMO 2018 Congress. 2018 Oct 20.
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