The Challenges and Opportunities of the Implementation of Comprehensive Genomic Profiling in Everyday Clinical Practice with Non-Small Cell Lung Cancer: National Results from Croatia
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Project Design
2.2. Comprehensive Genomic Profiling Analysis
2.3. Participants
2.4. Endpoints
2.5. Statistical Analysis
3. Results
3.1. Demographic Characteristics of Patients
3.2. Results of the CGP Testing
3.3. CGP-Guided Therapy
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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All Patients N (%) | ||
---|---|---|
FoundationOneCDx | 45 | (94) |
FoundationOne Liquid CDx | 3 | (6) |
Sex | ||
Male | 23 | (48) |
Female | 25 | (52) |
Age at the time of diagnosis, median (IQR) | 62 | (51.5–68) |
Metastatic disease at the initial diagnosis | 30 | (63) |
Disease progression | 15 | (31) |
Stage of the disease not determined | 3 | (6) |
Number of patients receiving previous chemotherapy | 37 | (77) |
Number of previous treatment lines for metastatic disease | ||
0 | 5 | (10) |
1 | 36 | (75) |
2 | 17 | (35) |
3 | 7 | (15) |
Not determined | 3 | (6) |
ECOG performance status before CGP * | ||
0 | 24 | (50) |
1 | 22 | (46) |
Not determined | 2 | (4) |
All Patients N (%) | ||
---|---|---|
Genomic alterations (N,%) | ||
Any genomic alteration | 46 | (96) |
Clinically relevant | 38 | (79) |
Not clinically relevant | 41 | (85) |
Number of genomic alterations, median (IQR) | ||
Clinically relevant | 2 | (1–3) |
Not clinically relevant | 3 | (2–4) |
Clinically relevant genomic alterations (N,%) | ||
KRAS | 16 | (33) |
STK11 | 15 | (31) |
KEAP | 6 | (13) |
MET | 5 | (10) |
CTNNB1 | 5 | (10) |
EGFR | 3 | (6) |
BRAF | 3 | (6) |
ROS1, ERBB2, RICTOR, MYC, ATM, | 2 | (4) |
CDK4, MDM2, CHEK2, MTAP | ||
RET, BRCA1, PIK3CA, SMARCBI, | 1 | (2) |
ERRFI1, MTAT, AKT2, AXL, CBL, | ||
CDKN1A, NF1 | ||
PD-L1 status † | 30 | (63) |
Negative | 7 | (23) |
Low positive (1–24%) | 13 | (43) |
Moderately positive (25–49%) | 3 | (10) |
Highly positive (≥50%) | 7 | (23) |
Not determined | 18 | (38) |
Microsatellite status | ||
Stable | 44 | (92) |
High instability | 0 | (0) |
Not determined | 4 | (8) |
Tumor mutational burden (TMB), median (IQR) | 8 | (4–13) |
Tumor mutational burden (TMB) | ||
Not high (<10 mutations/Mb) | 25 | (52) |
High (≥10 mutations/Mb) | 19 | (40) |
Not determined | 4 | (8) |
CRGA | Targeted Therapy | Treatment Duration Months (Outcome) |
---|---|---|
BRAF | Trametinib | 2 (DEATH) |
ROS1 | Crizotinib | 30 (ONGOING) |
High TMB | Atezolizumab | 4 (DEATH) |
KRAS | Sotorasib * | 16 (PROGRESSION) |
High TMB | Atezolizumab | 3 (DEATH) |
RET | Pralsetinib * | 27 (ONGOING) |
EGFR | Erlotinib | 29 (ONGOING) |
MET | Crizotinib | 5 (PROGRESSION) |
MET | Crizotinib | 18 (PROGRESSION) |
High TMB | Atezolizumab | 1 (DEATH) |
ROS1 | Crizotinib | 9 (PROGRESSION) |
High TMB | Atezolizumab | 1 (DEATH) |
EGFR | Osimertinib | 2 (DEATH) |
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Čerina, D.; Krpina, K.; Jakopović, M.; Dedić Plavetić, N.; Seiwerth, F.; Tomić, S.; Radić, J.; Belac Lovasić, I.; Canjko, I.; Boban, M.; et al. The Challenges and Opportunities of the Implementation of Comprehensive Genomic Profiling in Everyday Clinical Practice with Non-Small Cell Lung Cancer: National Results from Croatia. Cancers 2023, 15, 3395. https://doi.org/10.3390/cancers15133395
Čerina D, Krpina K, Jakopović M, Dedić Plavetić N, Seiwerth F, Tomić S, Radić J, Belac Lovasić I, Canjko I, Boban M, et al. The Challenges and Opportunities of the Implementation of Comprehensive Genomic Profiling in Everyday Clinical Practice with Non-Small Cell Lung Cancer: National Results from Croatia. Cancers. 2023; 15(13):3395. https://doi.org/10.3390/cancers15133395
Chicago/Turabian StyleČerina, Dora, Kristina Krpina, Marko Jakopović, Natalija Dedić Plavetić, Fran Seiwerth, Snježana Tomić, Jasna Radić, Ingrid Belac Lovasić, Ivana Canjko, Marijo Boban, and et al. 2023. "The Challenges and Opportunities of the Implementation of Comprehensive Genomic Profiling in Everyday Clinical Practice with Non-Small Cell Lung Cancer: National Results from Croatia" Cancers 15, no. 13: 3395. https://doi.org/10.3390/cancers15133395