Experience with precision genomics and tumor board, indicates frequent target identification, but barriers to delivery

Alan H. Bryce, Jan B. Egan, Mitesh J. Borad, A. Keith Stewart, Grzegorz S. Nowakowski, Asher Chanan-Khan, Mrinal M. Patnaik, Stephen M. Ansell, Michaela S. Banck, Steven I. Robinson, Aaron S. Mansfield, Eric W. Klee, Gavin R. Oliver, Jennifer B. McCormick, Norine E. Huneke, Colleen M. Tagtow, Robert B. Jenkins, Kandelaria M. Rumilla, Sarah E. Kerr, Jean Pierre A. KocherScott A. Beck, Martin E. Fernandez-Zapico, Gianrico Farrugia, Konstantinos N. Lazaridis, Robert R. McWilliams

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: The ability to analyze the genomics of malignancies has opened up new possibilities for off-label targeted therapy in cancers that are refractory to standard therapy. At Mayo Clinic these efforts are organized through the Center for Individualized Medicine (CIM). Results: Prior to GTB, datasets were analyzed and integrated by a team of bioinformaticians and cancer biologists. Therapeutically actionable mutations were identified in 65% (92/141) of the patients tested with 32% (29/92) receiving genomically targeted therapy with FDA approved drugs or in an independent clinical trial with 45% (13/29) responding. Standard of care (SOC) options were continued by 15% (14/92) of patients tested before exhausting SOC options, with 71% (10/14) responding to treatment. Over 35% (34/92) of patients with actionable targets were not treated with 65% (22/34) choosing comfort measures or passing away. Materials and Methods: Patients (N = 165) were referred to the CIM Clinic between October 2012 and December 2015. All patients received clinical genomic panel testing with selected subsets receiving array comparative genomic hybridization and clinical whole exome sequencing to complement and validate panel findings. A genomic tumor board (GTB) reviewed results and, when possible, developed treatment recommendations.Conclusions: Treatment decisions driven by tumor genomic analysis can lead to significant clinical benefit in a minority of patients. The success of genomically driven therapy depends both on access to drugs and robustness of bioinformatics analysis. While novel clinical trial designs are increasing the utility of genomic testing, robust data sharing of outcomes is needed to optimize clinical benefit for all patients.

Original languageEnglish (US)
Pages (from-to)27145-27154
Number of pages10
JournalOncotarget
Volume8
Issue number16
DOIs
StatePublished - Jan 1 2017

Fingerprint

Genomics
Neoplasms
Precision Medicine
Standard of Care
Therapeutics
Clinical Trials
Exome
Comparative Genomic Hybridization
Information Dissemination
Computational Biology
Pharmaceutical Preparations
Mutation

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Bryce, A. H., Egan, J. B., Borad, M. J., Keith Stewart, A., Nowakowski, G. S., Chanan-Khan, A., ... McWilliams, R. R. (2017). Experience with precision genomics and tumor board, indicates frequent target identification, but barriers to delivery. Oncotarget, 8(16), 27145-27154. https://doi.org/10.18632/oncotarget.16057
Bryce, Alan H. ; Egan, Jan B. ; Borad, Mitesh J. ; Keith Stewart, A. ; Nowakowski, Grzegorz S. ; Chanan-Khan, Asher ; Patnaik, Mrinal M. ; Ansell, Stephen M. ; Banck, Michaela S. ; Robinson, Steven I. ; Mansfield, Aaron S. ; Klee, Eric W. ; Oliver, Gavin R. ; McCormick, Jennifer B. ; Huneke, Norine E. ; Tagtow, Colleen M. ; Jenkins, Robert B. ; Rumilla, Kandelaria M. ; Kerr, Sarah E. ; Kocher, Jean Pierre A. ; Beck, Scott A. ; Fernandez-Zapico, Martin E. ; Farrugia, Gianrico ; Lazaridis, Konstantinos N. ; McWilliams, Robert R. / Experience with precision genomics and tumor board, indicates frequent target identification, but barriers to delivery. In: Oncotarget. 2017 ; Vol. 8, No. 16. pp. 27145-27154.
@article{326eebb101184737864c62ff0d3579c1,
title = "Experience with precision genomics and tumor board, indicates frequent target identification, but barriers to delivery",
abstract = "Background: The ability to analyze the genomics of malignancies has opened up new possibilities for off-label targeted therapy in cancers that are refractory to standard therapy. At Mayo Clinic these efforts are organized through the Center for Individualized Medicine (CIM). Results: Prior to GTB, datasets were analyzed and integrated by a team of bioinformaticians and cancer biologists. Therapeutically actionable mutations were identified in 65{\%} (92/141) of the patients tested with 32{\%} (29/92) receiving genomically targeted therapy with FDA approved drugs or in an independent clinical trial with 45{\%} (13/29) responding. Standard of care (SOC) options were continued by 15{\%} (14/92) of patients tested before exhausting SOC options, with 71{\%} (10/14) responding to treatment. Over 35{\%} (34/92) of patients with actionable targets were not treated with 65{\%} (22/34) choosing comfort measures or passing away. Materials and Methods: Patients (N = 165) were referred to the CIM Clinic between October 2012 and December 2015. All patients received clinical genomic panel testing with selected subsets receiving array comparative genomic hybridization and clinical whole exome sequencing to complement and validate panel findings. A genomic tumor board (GTB) reviewed results and, when possible, developed treatment recommendations.Conclusions: Treatment decisions driven by tumor genomic analysis can lead to significant clinical benefit in a minority of patients. The success of genomically driven therapy depends both on access to drugs and robustness of bioinformatics analysis. While novel clinical trial designs are increasing the utility of genomic testing, robust data sharing of outcomes is needed to optimize clinical benefit for all patients.",
author = "Bryce, {Alan H.} and Egan, {Jan B.} and Borad, {Mitesh J.} and {Keith Stewart}, A. and Nowakowski, {Grzegorz S.} and Asher Chanan-Khan and Patnaik, {Mrinal M.} and Ansell, {Stephen M.} and Banck, {Michaela S.} and Robinson, {Steven I.} and Mansfield, {Aaron S.} and Klee, {Eric W.} and Oliver, {Gavin R.} and McCormick, {Jennifer B.} and Huneke, {Norine E.} and Tagtow, {Colleen M.} and Jenkins, {Robert B.} and Rumilla, {Kandelaria M.} and Kerr, {Sarah E.} and Kocher, {Jean Pierre A.} and Beck, {Scott A.} and Fernandez-Zapico, {Martin E.} and Gianrico Farrugia and Lazaridis, {Konstantinos N.} and McWilliams, {Robert R.}",
year = "2017",
month = "1",
day = "1",
doi = "10.18632/oncotarget.16057",
language = "English (US)",
volume = "8",
pages = "27145--27154",
journal = "Oncotarget",
issn = "1949-2553",
publisher = "Impact Journals",
number = "16",

}

Bryce, AH, Egan, JB, Borad, MJ, Keith Stewart, A, Nowakowski, GS, Chanan-Khan, A, Patnaik, MM, Ansell, SM, Banck, MS, Robinson, SI, Mansfield, AS, Klee, EW, Oliver, GR, McCormick, JB, Huneke, NE, Tagtow, CM, Jenkins, RB, Rumilla, KM, Kerr, SE, Kocher, JPA, Beck, SA, Fernandez-Zapico, ME, Farrugia, G, Lazaridis, KN & McWilliams, RR 2017, 'Experience with precision genomics and tumor board, indicates frequent target identification, but barriers to delivery', Oncotarget, vol. 8, no. 16, pp. 27145-27154. https://doi.org/10.18632/oncotarget.16057

Experience with precision genomics and tumor board, indicates frequent target identification, but barriers to delivery. / Bryce, Alan H.; Egan, Jan B.; Borad, Mitesh J.; Keith Stewart, A.; Nowakowski, Grzegorz S.; Chanan-Khan, Asher; Patnaik, Mrinal M.; Ansell, Stephen M.; Banck, Michaela S.; Robinson, Steven I.; Mansfield, Aaron S.; Klee, Eric W.; Oliver, Gavin R.; McCormick, Jennifer B.; Huneke, Norine E.; Tagtow, Colleen M.; Jenkins, Robert B.; Rumilla, Kandelaria M.; Kerr, Sarah E.; Kocher, Jean Pierre A.; Beck, Scott A.; Fernandez-Zapico, Martin E.; Farrugia, Gianrico; Lazaridis, Konstantinos N.; McWilliams, Robert R.

In: Oncotarget, Vol. 8, No. 16, 01.01.2017, p. 27145-27154.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Experience with precision genomics and tumor board, indicates frequent target identification, but barriers to delivery

AU - Bryce, Alan H.

AU - Egan, Jan B.

AU - Borad, Mitesh J.

AU - Keith Stewart, A.

AU - Nowakowski, Grzegorz S.

AU - Chanan-Khan, Asher

AU - Patnaik, Mrinal M.

AU - Ansell, Stephen M.

AU - Banck, Michaela S.

AU - Robinson, Steven I.

AU - Mansfield, Aaron S.

AU - Klee, Eric W.

AU - Oliver, Gavin R.

AU - McCormick, Jennifer B.

AU - Huneke, Norine E.

AU - Tagtow, Colleen M.

AU - Jenkins, Robert B.

AU - Rumilla, Kandelaria M.

AU - Kerr, Sarah E.

AU - Kocher, Jean Pierre A.

AU - Beck, Scott A.

AU - Fernandez-Zapico, Martin E.

AU - Farrugia, Gianrico

AU - Lazaridis, Konstantinos N.

AU - McWilliams, Robert R.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: The ability to analyze the genomics of malignancies has opened up new possibilities for off-label targeted therapy in cancers that are refractory to standard therapy. At Mayo Clinic these efforts are organized through the Center for Individualized Medicine (CIM). Results: Prior to GTB, datasets were analyzed and integrated by a team of bioinformaticians and cancer biologists. Therapeutically actionable mutations were identified in 65% (92/141) of the patients tested with 32% (29/92) receiving genomically targeted therapy with FDA approved drugs or in an independent clinical trial with 45% (13/29) responding. Standard of care (SOC) options were continued by 15% (14/92) of patients tested before exhausting SOC options, with 71% (10/14) responding to treatment. Over 35% (34/92) of patients with actionable targets were not treated with 65% (22/34) choosing comfort measures or passing away. Materials and Methods: Patients (N = 165) were referred to the CIM Clinic between October 2012 and December 2015. All patients received clinical genomic panel testing with selected subsets receiving array comparative genomic hybridization and clinical whole exome sequencing to complement and validate panel findings. A genomic tumor board (GTB) reviewed results and, when possible, developed treatment recommendations.Conclusions: Treatment decisions driven by tumor genomic analysis can lead to significant clinical benefit in a minority of patients. The success of genomically driven therapy depends both on access to drugs and robustness of bioinformatics analysis. While novel clinical trial designs are increasing the utility of genomic testing, robust data sharing of outcomes is needed to optimize clinical benefit for all patients.

AB - Background: The ability to analyze the genomics of malignancies has opened up new possibilities for off-label targeted therapy in cancers that are refractory to standard therapy. At Mayo Clinic these efforts are organized through the Center for Individualized Medicine (CIM). Results: Prior to GTB, datasets were analyzed and integrated by a team of bioinformaticians and cancer biologists. Therapeutically actionable mutations were identified in 65% (92/141) of the patients tested with 32% (29/92) receiving genomically targeted therapy with FDA approved drugs or in an independent clinical trial with 45% (13/29) responding. Standard of care (SOC) options were continued by 15% (14/92) of patients tested before exhausting SOC options, with 71% (10/14) responding to treatment. Over 35% (34/92) of patients with actionable targets were not treated with 65% (22/34) choosing comfort measures or passing away. Materials and Methods: Patients (N = 165) were referred to the CIM Clinic between October 2012 and December 2015. All patients received clinical genomic panel testing with selected subsets receiving array comparative genomic hybridization and clinical whole exome sequencing to complement and validate panel findings. A genomic tumor board (GTB) reviewed results and, when possible, developed treatment recommendations.Conclusions: Treatment decisions driven by tumor genomic analysis can lead to significant clinical benefit in a minority of patients. The success of genomically driven therapy depends both on access to drugs and robustness of bioinformatics analysis. While novel clinical trial designs are increasing the utility of genomic testing, robust data sharing of outcomes is needed to optimize clinical benefit for all patients.

UR - http://www.scopus.com/inward/record.url?scp=85017522803&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85017522803&partnerID=8YFLogxK

U2 - 10.18632/oncotarget.16057

DO - 10.18632/oncotarget.16057

M3 - Article

C2 - 28423702

AN - SCOPUS:85017522803

VL - 8

SP - 27145

EP - 27154

JO - Oncotarget

JF - Oncotarget

SN - 1949-2553

IS - 16

ER -

Bryce AH, Egan JB, Borad MJ, Keith Stewart A, Nowakowski GS, Chanan-Khan A et al. Experience with precision genomics and tumor board, indicates frequent target identification, but barriers to delivery. Oncotarget. 2017 Jan 1;8(16):27145-27154. https://doi.org/10.18632/oncotarget.16057