Precision Medicine in Oncology®

Improving patient outcomes is top of mind for investigators at John Theurer Cancer Center in Hackensack, New Jersey.

Upal Basu Roy, PhD, MPH, discusses the challenges of interpreting molecular testing results in lung cancer.

Maurie Markman, MD, explains the concerns surrounding liquid biopsies in cancer screening, and why regulatory agencies should be cautious and not approve any proposed molecularly based cancer diagnostic screening strategy until the tool is shown to effect cancer-specific survival compared with a control population not undergoing such testing.

Primary and metastatic brain tumors present a significant therapeutic challenge, in large part because they are protected by the blood-brain barrier, a highly restrictive interface between the bloodstream and the brain that prevents most drugs from accessing the brain parenchyma.

The European Commission has granted a marketing authorization for lorlatinib for use as a single agent in the treatment of adult patients with ALK-positive advanced non–small cell lung cancer who did not receive a prior ALK inhibitor.

The recent approval of sotorasib for the treatment of patients with advanced KRAS G12C–mutant non–small cell lung cancer marks a milestone for cancer therapy.

High expression of activated leukocyte cell adhesion molecule, also known as CD166, occurs in approximately 50% of patients with triple-negative breast cancer and up to 80% of patients with estrogen receptor– positive, HER2-negative breast cancer.

Molecular testing is an established and essential precursor to treatment for patients with non–small cell lung cancer based on the volume of actionable targets, such as EGFR and KRAS G12C mutations, as well as PD-L1 status.

Bintrafusp Alfa, a novel fusion protein designed to target the transforming growth factor beta pathway, racked up 3 clinical trial disappointments in less than a year, leaving the future of its development in question.

The FDA has approved FoundationOne CDx for use as a companion diagnostic for 2 groups of current a future regulatory-approved treatments in melanoma, including single-agent BRAF inhibitors targeting BRAF V600E mutations and BRAF/MEK combination regimens targeting BRAF V600E or V600K mutations.

The use of a routine blood test to assess and monitor patients with cancer, especially in a longitudinal manner, has long been the holy grail of cancer research.

Investigators identified potentially actionable germline variants in 10% of unselected women with newly diagnosed endometrial cancer, supporting the use of upfront multigene panel testing for all in the population.

Shridar Ganesan, MD, PhD, discusses improvements in precision medicine and the need to enroll patients with different molecular subtypes into specifically designed clinical trials.

Maher Albitar, MD, discusses the importance of obtaining genomic testing in oncology.

The Food and Drug Administration has granted recognition to a partial listing of the Oncology Knowledge Base, a comprehensive precision oncology knowledge databased developed by investigators and physicians at Memorial Sloan Kettering Cancer Center.

Radiation oncologists Jacob Scott, MD, DPhil, and Javier Torres-Roca, MD, discuss the benefits of using GARD in a pooled pan-cancer analysis and why there is a call to action to integrate GARD-based radiotherapy dosing in oncology.

Maher Albitar, MD, discusses the unmet needs with genomic testing that served as the impetus to start GTC, the process of becoming a partner with the organization, and the importance of genomic profiling for all patients with cancer.

Melissa L. Johnson, MD, discusses the potential utility of TROP2 as a therapeutic target for all-comers with solid tumor malignancies.

The ATR inhibitor RP-3500 demonstrated a manageable safety profile and promising early antitumor efficacy in patients whose tumors harbor select genomic alterations when administered at doses of 100 mg or more.

The FDA has approved the VENTANA PD-L1 assay to assist in identifying which adult patients with stage II to IIIA non–small cell lung cancer whose tumors have PD-L1 expression on 1% or more of tumor cells are eligible to receive adjuvant atezolizumab following surgery and platinum-based chemotherapy.

The FDA has approved the Ki-67 IHC MIB-1 pharmDx test to assist in determining which patients with early breast cancer who are at high risk of disease recurrence might benefit from adjuvant treatment with abemaciclib plus endocrine therapy.

Patritumab deruxtecan, a novel antibody-drug conjugate, is emerging as a promising HER3-directed therapy in patients with non–small cell lung cancer and perhaps other solid malignancies.

Investigators have expanded the scientific understanding of cancer in the adolescent young adult patient population over the past decade. However, unmet needs remain in establishing treatment standards, addressing unique survivorship challenges, and providing a framework for patients to reference as they navigate their cancer journey.

The sustainability of next-generation sequencing will be dependent on the implementation of thorough informatics and infrastructure that can support the integration of genomic results into electronic medical records.

Andre H. Goy, MD, discusses the importance of refined decision making with precision medicine.

John L. Marshall, MD, discusses the importance of molecular profiling when utilizing precision medicine.

Benjamin P. Levy, MD, discusses potential strategies to overcome resistance to osimertinib in EGFR-mutant non–small cell lung cancer. 

Clinical limit of detection may be a reasonable metric for evaluating cell-free DNA for multi-cancer early detection.

Current approaches to precision medicine in oncology have been fruitful, but require better integration and utilization of available resources to inform sustainable and effective drug development and clinical care, according to Andre Goy, MD.