Clinical relevance of comprehensive genomic profiling for advanced cancers in India.

Authors

null

Serena Elizabeth Joseph

MOSC Medical College, Kolenchery, Ernakulam, India

Serena Elizabeth Joseph , Aju Mathew , Senthill J. Rajappa , Nitesh Rohatgi , Bhawna Sirohi , Reetu Jain , Vivek Agarwala , Deepak Kumar Shukla , Anurag Mehta , Raja Pramanik , Vineet Talwar , Vinayak Maka , Nirmal Vivek Raut

Organizations

MOSC Medical College, Kolenchery, Ernakulam, India, University of Kentucky Markey Cancer Center, Lexington, KY, Indo American Cancer Hospital and Research Institute, Hyderabad, India, Max Cancer Center, Delhi, India, Apollo Proton Cancer Centre, Chennai, India, Jaslok Hospital, Mumbai, India, Tata Memorial Centre, Mumbai, India, Manipal Hospital, Jaipur, India, Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India, All India Institute of Medical Sciences, New Delhi, India, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India, M S Ramaiah Medical College, Bengaluru, India, Bhaktivedanta Hospital And Research Institute, Mumbai, Maharashtra, India

Research Funding

No funding received
None

Background: Comprehensive genomic profiling (CGP) assay, a next-generation sequencing (NGS) based technique generates a large amount of genomic information about a cancer. While CGP is increasingly used in low-middle income countries (LMIC), little is known about the extent to which these benefits patients. Here we describe the proportion of patients with advanced cancer in India who eventually receive targeted therapy for an actionable genetic alteration identified on CGP assays. Methods: This was a multicenter, retrospective cohort study in adult patients with advanced non-hematological malignancies who underwent a CGP test. We excluded patients who were identified to have a genetic alteration that has a well-validated targeted standard-of-care therapy (e.g.; EGFR exon 18, 19, 21 mutations for lung cancer, HER2 amplification for breast cancer). Participating oncologists provided anonymized information of consecutive CGP test reports through an online data capture form. Descriptive statistics were used to describe the proportion of patients with subsequent targeted therapy. Results: During 2019-20, 12 medical oncologists provided CGP reports for 297 patients; 235 met the inclusion criteria. Fourteen different testing panels were used by the oncologists. Among the study cohort, 45% were male. Eighty nine percent underwent tumor tissue biopsy and 11% had liquid biopsy. The most common cancers were lung (19%), breast (18%), pancreatobiliary (9%) and colorectal (6%). Patients received a median of 2 lines (range: 0-5) of prior systemic therapy. Based on the CGP assay, 35 patients (15%) received targeted therapy. Among them, 29% was for HER2 amplification (non-breast cancer), 26% for PIK3CA mutation, 11% for HER2 or EGFR exon 20 insertion mutation (lung cancer), 5% each for BRAF mutation (non-melanoma), EGFR mutation (non-lung cancer) and MET mutation. Conclusions: In a LMIC setting, 15% patients received a targeted therapy based on CGP assay. This is comparable to reports from high income countries. Considering the limited access to new drugs and clinical trials, this finding requires further analysis.

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Health Services Research and Quality Improvement

Track

Quality Care/Health Services Research

Sub Track

Real-World Data/Outcomes

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr e18718)

DOI

10.1200/JCO.2021.39.15_suppl.e18718

Abstract #

e18718

Abstract Disclosures