Clinical Utility of Genomic Profiling in the Treatment of Advanced Sarcomas

A Single-Center Experience

Spandana Boddu; Christine M. Walko; Stephanie Bienasz; Marilyn M. Bui; Evita Henderson-Jackson; Arash O. Naghavi; John E. Mullinax; David M. Joyce; Odion Binitie; G. Douglas Letson; Ricardo J. Gonzalez; Damon R. Reed; Mihaela Druta; Andrew S. Brohl

Disclosures

JCO Precis Oncol. 2018;2(1) 

In This Article

Abstract and Introduction

Abstract

Purpose: Sarcomas are a diverse group of malignant tumors that arise from soft tissues or bone. For most advanced cases, there is a substantial need for improved therapeutic options and, therefore, a desire to more precisely tailor therapy in individual cases. In this study, we review our institutional experience with next-generation sequencing (NGS)–based molecular profiling for non–GI stromal tumors sarcomas, with a focus on the clinical utility of the results.

Patients and Methods: We retrospectively analyzed results of NGS performed on tumors from 114 patients with a diagnosis of sarcoma. A chart review was conducted to review the clinical impact of NGS findings.

Results: A median of three putatively oncogenic gene alterations were identified per tumor sample (range, 0 to 19) and at least one mutation was detected in 96.7% of tumors. Fifty-six patients (49.1%) harbored a finding that was felt to be actionable after review by a molecular tumor board. Five patients (4.4%) had a diagnosis change as a result of NGS findings. In 15 patients (13.2%), therapeutic selection was influenced by NGS findings. Four of 15 (26.7%) of the NGS-influenced systemic therapies resulted in clinical benefit.

Conclusion: Putatively oncogenic mutations are readily detected in the majority of sarcomas. Genetic profiling affected the diagnosis and/or treatment approach in a sizeable minority of patients with sarcoma treated at our center. Additional study is required to determine if genetic profiling leads to improved clinical outcomes.

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