Cancers (Apr 2024)

NGS-Guided Precision Oncology in Breast Cancer and Gynecological Tumors—A Retrospective Molecular Tumor Board Analysis

  • Niklas Gremke,
  • Fiona R. Rodepeter,
  • Julia Teply-Szymanski,
  • Sebastian Griewing,
  • Jelena Boekhoff,
  • Alina Stroh,
  • Thomas S. Tarawneh,
  • Jorge Riera-Knorrenschild,
  • Christina Balser,
  • Akira Hattesohl,
  • Martin Middeke,
  • Petra Ross,
  • Anne-Sophie Litmeyer,
  • Marcel Romey,
  • Thorsten Stiewe,
  • Thomas Wündisch,
  • Andreas Neubauer,
  • Carsten Denkert,
  • Uwe Wagner,
  • Elisabeth K. M. Mack

DOI
https://doi.org/10.3390/cancers16081561
Journal volume & issue
Vol. 16, no. 8
p. 1561

Abstract

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Background: Precision oncology treatments are being applied more commonly in breast and gynecological oncology through the implementation of Molecular Tumor Boards (MTBs), but real-world clinical outcome data remain limited. Methods: A retrospective analysis was conducted in patients with breast cancer (BC) and gynecological malignancies referred to our center’s MTB from 2018 to 2023. The analysis covered patient characteristics, next-generation sequencing (NGS) results, MTB recommendations, therapy received, and clinical outcomes. Results: Sixty-three patients (77.8%) had metastatic disease, and forty-four patients (54.3%) had previously undergone three or more lines of systemic treatment. Personalized treatment recommendations were provided to 50 patients (63.3%), while 29 (36.7%) had no actionable target. Ultimately, 23 patients (29.1%) underwent molecular-matched treatment (MMT). Commonly altered genes in patients with pan-gyn tumors (BC and gynecological malignancies) included TP53 (n = 42/81, 51.9%), PIK3CA (n = 18/81, 22.2%), BRCA1/2 (n = 10/81, 12.3%), and ARID1A (n = 9/81, 11.1%). Patients treated with MMT showed significantly prolonged progression-free survival (median PFS 5.5 vs. 3.5 months, p = 0.0014). Of all patients who underwent molecular profiling, 13.6% experienced a major clinical benefit (PFSr ≥ 1.3 and PR/SD ≥ 6 months) through precision oncology. Conclusions: NGS-guided precision oncology demonstrated improved clinical outcomes in a subgroup of patients with gynecological and breast cancers.

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