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1.
Br J Cancer ; 125(9): 1261-1269, 2021 10.
Article in English | MEDLINE | ID: mdl-34493820

ABSTRACT

INTRODUCTION: Molecular-matched therapies have revolutionized cancer treatment. We evaluated the improvement in clinical outcomes of applying an in-house customized Next Generation Sequencing panel in a single institution. METHODS: Patients with advanced solid tumors were molecularly selected to receive a molecular-matched treatment into early phase clinical trials versus best investigators choice, according to the evaluation of a multidisciplinary molecular tumor board. The primary endpoint was progression-free survival (PFS) assessed by the ratio of patients presenting 1.3-fold longer PFS on matched therapy (PFS2) than with prior therapy (PFS1). RESULTS: Of a total of 231 molecularly screened patients, 87 were eligible for analysis. Patients who received matched therapy had a higher median PFS2 (6.47 months; 95% CI, 2.24-14.43) compared to those who received standard therapy (2.76 months; 95% CI, 2.14-3.91, Log-rank p = 0.022). The proportion of patients with a PFS2/PFS1 ratio over 1.3 was significantly higher in the experimental arm (0.33 vs 0.08; p = 0.008). DISCUSSION: We demonstrate the pivotal role of the institutional molecular tumor board in evaluating the results of a customized NGS panel. This process optimizes the selection of available therapies, improving disease control. Prospective randomized trials are needed to confirm this approach and open the door to expanded drug access.


Subject(s)
Molecular Targeted Therapy/methods , Neoplasms/genetics , Sequence Analysis, DNA/methods , Adult , Aged , Aged, 80 and over , Bayes Theorem , Clinical Trials as Topic , Disease-Free Survival , Female , High-Throughput Nucleotide Sequencing , Humans , Male , Middle Aged , Neoplasms/drug therapy , Precision Medicine , Prospective Studies , Standard of Care
2.
Cancer Treat Rev ; 99: 102263, 2021 Sep.
Article in English | MEDLINE | ID: mdl-34343892

ABSTRACT

The application of imaging biomarkers in oncology is still in its infancy, but with the expansion of radiomics and radiogenomics a revolution is expected in this field. This may be of special interest in head and neck cancer, since it can promote precision medicine and personalization of treatment by overcoming several intrinsic obstacles in this pathology. Our goal is to provide the medical oncologist with the basis to approach these disciplines and appreciate their main uses in clinical research and clinical practice in the medium term. Aligned with this objective we analyzed the most relevant studies in the field, also highlighting novel opportunities and current challenges.


Subject(s)
Head and Neck Neoplasms/diagnostic imaging , Head and Neck Neoplasms/genetics , Squamous Cell Carcinoma of Head and Neck/diagnostic imaging , Squamous Cell Carcinoma of Head and Neck/genetics , Biomarkers, Tumor , Decision Making , Diagnostic Techniques, Radioisotope , Head and Neck Neoplasms/therapy , Humans , Machine Learning , Precision Medicine , Prognosis , Squamous Cell Carcinoma of Head and Neck/therapy
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