Pan-cancer molecular tumor board experience with biomarker-driven precision immunotherapy

Bryan H. Louie, Shumei Kato, Ki Hwan Kim, Hyo Jeong Lim, Ryosuke Okamura, Ramez N. Eskander, Gregory Botta, Hitendra Patel, Suzanna Lee, Scott M. Lippman, Jason K. Sicklick, Razelle Kurzrock

Research output: Contribution to journalArticlepeer-review

Abstract

Despite remarkable responses to immune checkpoint blockade (ICB) in some advanced cancers, most patients do not benefit, perhaps due to the complexity of tumor/immune/genome interactions. We implemented a multidisciplinary Molecular Tumor Board (MTB) that reviewed multi-omic cancer characteristics to develop N-of-One therapies for patients in the pan-cancer, advanced, refractory setting. This study evaluates the experience of 80 patients who were presented to the MTB and received a treatment regimen that included ICB. Overall, 60/80 patients (75%) who received ICB following MTB discussion had a high degree of matching between tumor molecular characteristics, including ICB biomarkers (reflected by a high Matching Score (≥50%)) and therapy administered. Patients with high versus low Matching Score experienced significantly longer median progression-free survival (6.4 vs. 3.0 months; p = 0.011) and median overall survival (15.3 vs. 4.7 months; p = 0.014) and higher clinical benefit rates (stable disease ≥6 months/partial response/complete response) (53% vs. 21%, p = 0.019). Although most patients (52/80 (65%)) received a personalized combination therapy (e.g., targeted, hormonal, chemotherapy, or a second immunotherapy agent), administering >1 drug was not associated with outcome. Only degree of matching and age, but no other variables, including individual biomarkers (e.g., microsatellite status, tumor mutational burden, or PD-L1 status), were independently correlated with outcome. In the pan-cancer setting, the MTB facilitated a precision medicine strategy to match therapeutic regimens that included ICB alone or combined with matched targeted drugs to patients with advanced malignancy, which was associated with improved clinical outcomes.

Original languageEnglish
Article number67
Journalnpj Precision Oncology
Volume6
Issue number1
DOIs
StatePublished - Dec 2022

Fingerprint

Dive into the research topics of 'Pan-cancer molecular tumor board experience with biomarker-driven precision immunotherapy'. Together they form a unique fingerprint.

Cite this