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Evidence-based Molecular Profiling for Solid Tumours – The Future is Now

European Oncology & Haematology, 2012;8(4):242-7 DOI: https://doi.org/10.17925/EOH.2012.08.4.242

Abstract

Advances in our understanding of the molecular basis of cancer have shown that biomarkers can help guide therapy in a growing number of cancer types and that targeted therapies are becoming increasingly integral to cancer management. However, how to interpret the rapidly expanding wealth of data on cancer genomics and ensure that the best evidence is effectively translated into an optimal individualised therapeutic strategy, remains a challenge. Caris Target Now™ is a well-established, evidence-based molecular profiling service provided by Caris Life Sciences (Basel, Switzerland). Caris Target Now utilises the latest diagnostic molecular assay technologies to determine the unique biomarkers of a patient’s tumour. This is combined with an extensive review of the published clinical evidence to correlate predictive biomarkers with drug response, in order to reveal the potential benefit (or lack of benefit) of specific therapeutic agents. By this process, Target Now provides tumour-specific information that can be used to help physicians personalise cancer therapy for their patients.

Keywords

Personalised care, targeted therapy, genomics, molecular profiling, biomarkers

Disclosure

Both authors are employees of Caris Life Sciences.

Received

August 22, 2012

Accepted

September 12, 2012

Correspondence

Andreas Voss, Caris Life Sciences Europe, CityGate, St Jakobsstrasse 199, CH-4052 Basel, Switzerland. E: avoss@carisls.com

Support

The publication of this article was funded by Caris Life Sciences.

Personalised cancer care is becoming an increasingly important aspect of oncological practice. With the advent of high-throughput molecular profiling technology, it is now possible to identify the unique characteristics of a specific tumour and use this information to tailor treatment to the individual patient. Identification of relevant biomarkers, which include genes, proteins and other molecules, can help to ensure that specific treatments are targeted to those patients who are most likely to gain optimal benefit while avoiding the side effects of ineffective therapy. On a societal level, a personalised approach offers the potential to substantially reduce health care costs, by reducing treatment use in patients unlikely to benefit. This is especially important given the rapidly escalating economic burden of cancer that is, in part, driven by the expense of innovative new treatments.1

Most cancer therapies gain approval despite typical response rates of around only one-third of patients.2 Thus, a significant proportion of cancer patients receive treatment of limited clinical benefit. Better targeted clinical decision-making early in the disease course would improve outcomes for patients. More comprehensive and earlier use of molecular profiling could result in more patients receiving effective therapy at a stage where benefits may be optimal rather than after one or more lines of failed treatment, an especially important consideration in aggressive cancers for which the time window for effective intervention may be limited. It may also mean that patients with rare cancers, which have a limited evidence-base and fewtreatment options, may be able to benefit from existing targeted therapies. A more personalised approach to patient care, with targeted treatment directed by the molecular profile of the tumour rather than a ‘one-size-fits-all’ strategy, would also lead to more effective allocation of limited financial resources.

Over the past decade, an increasing number of targeted therapies to treat different types of cancer have been introduced and have contributed to improvements in survival rates. Among the first successful targeted agents in cancer were trastuzumab (Herceptin®) for breast cancer overexpressing the Human epidermal growth factor receptor 2 (HER2) receptor and imatinib mesylate (Gleevec®) for abnormal protein tyrosine kinase activity in chronic myeloid leukemia and gastrointestinal stromal tumours. Other examples of targeted therapies include erlotinib (Tarceva®) and gefitinib (Iressa®), both of which target epidermal growth factor receptor (EGFR)-expressing non-small-cell lung cancer (NSCLC), cetuximab (Erbitux®) for patients with EGFR-expressing metastatic colorectal cancer, crizotinib (Xalkori®) for patients with locally advanced or metastatic NSCLC that is anaplastic lymphoma kinase (ALK)-positive, and vemurafenib (Zelboraf®) for BRAF V600E mutation-positive metastatic melanoma. These treatments, and many other targeted therapies, are changing the therapeutic landscape in oncology.

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