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Genome-matched treatments and patient outcomes in the Maine Cancer Genomics Initiative (MCGI).
Anderson, Eric C; DiPalazzo, John; Lucas, F Lee; Hall, Michael J; Antov, Andrey; Helbig, Petra; Bourne, Jennifer; Graham, Leah; Gaitor, Lory; Lu-Emerson, Christine; Bradford, Leslie S; Inhorn, Roger; Sinclair, Sarah J; Brooks, Philip L; Thomas, Christian A; Rasmussen, Karen; Han, Paul K J; Liu, Edison T; Rueter, Jens.
Afiliación
  • Anderson EC; Center for Interdisciplinary Population and Health Research, MaineHealth Institute for Research, Portland, ME, USA.
  • DiPalazzo J; Tufts University School of Medicine, Boston, MA, USA.
  • Lucas FL; Center for Interdisciplinary Population and Health Research, MaineHealth Institute for Research, Portland, ME, USA.
  • Hall MJ; Center for Interdisciplinary Population and Health Research, MaineHealth Institute for Research, Portland, ME, USA.
  • Antov A; Fox Chase Cancer Center, Philadelphia, PA, USA.
  • Helbig P; The Jackson Laboratory, Augusta, ME, USA.
  • Bourne J; The Jackson Laboratory, Augusta, ME, USA.
  • Graham L; The Jackson Laboratory, Augusta, ME, USA.
  • Gaitor L; The Jackson Laboratory, Augusta, ME, USA.
  • Lu-Emerson C; The Jackson Laboratory, Augusta, ME, USA.
  • Bradford LS; MaineHealth Cancer Care, South Portland, ME, USA.
  • Inhorn R; Maine Medical Partners Women's Health, Gynecologic Oncology, Scarborough, ME, USA.
  • Sinclair SJ; PenBay Medical Center Oncology, Rockport, ME, USA.
  • Brooks PL; Northern Light Cancer Institute, Brewer, ME, USA.
  • Thomas CA; Northern Light Cancer Institute, Brewer, ME, USA.
  • Rasmussen K; New England Cancer Specialists, Scarborough, ME, USA.
  • Han PKJ; Spectrum Healthcare, South Portland, ME, USA.
  • Liu ET; Center for Interdisciplinary Population and Health Research, MaineHealth Institute for Research, Portland, ME, USA.
  • Rueter J; National Cancer Institute, Bethesda, MD, USA.
NPJ Precis Oncol ; 8(1): 67, 2024 Mar 09.
Article en En | MEDLINE | ID: mdl-38461318
ABSTRACT
Genomic tumor testing (GTT) is an emerging technology aimed at identifying variants in tumors that can be targeted with genomically matched drugs. Due to limited resources, rural patients receiving care in community oncology settings may be less likely to benefit from GTT. We analyzed GTT results and observational clinical outcomes data from patients enrolled in the Maine Cancer Genomics Initiative (MCGI), which provided access to GTTs; clinician educational resources; and genomic tumor boards in community practices in a predominantly rural state. 1603 adult cancer patients completed enrollment; 1258 had at least one potentially actionable variant identified. 206 (16.4%) patients received a total of 240 genome matched treatments, of those treatments, 64% were FDA-approved in the tumor type, 27% FDA-approved in a different tumor type and 9% were given on a clinical trial. Using Inverse Probability of Treatment Weighting to adjust for baseline characteristics, a Cox proportional hazards model demonstrated that patients who received genome matched treatment were 31% less likely to die within 1 year compared to those who did not receive genome matched treatment (HR 0.69; 95% CI 0.52-0.90; p-value 0.006). Overall, GTT through this initiative resulted in levels of genome matched treatment that were similar to other initiatives, however, clinical trials represented a smaller share of treatments than previously reported, and "off-label" treatments represented a greater share. Although this was an observational study, we found evidence for a potential 1-year survival benefit for patients who received genome matched treatments. These findings suggest that when disseminated and implemented with a supportive infrastructure, GTT may benefit cancer patients in rural community oncology settings, with further work remaining on providing genome-matched clinical trials.

Texto completo: 1 Bases de datos: MEDLINE Idioma: En Revista: NPJ Precis Oncol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Bases de datos: MEDLINE Idioma: En Revista: NPJ Precis Oncol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos