Pilot study utilises molecular profiling to find potential targets and select treatments for refractory cancers

21 Apr 2009

Patients with advanced cancers, which had progressed on standard therapies and who had their tumours undergo molecular profiling, were able to be placed on chemotherapy regimens that had demonstrated effects on tumour size and progression-free survival.

Daniel Von Hoff, M.D., senior investigator and physician-in-chief at TGen, a non-profit research institute in Arizona, and chief scientific officer of Scottsdale Healthcare and U.S. Oncology Research, said this trial demonstrates the efficacy of personalised medicine. 

"These patients had their tumours evaluated using immunohistochemistry and microarray profiling, used in a rigorous clinical setting," he said. 

Von Hoff and colleagues applied these techniques to 66 patients at nine centers and selected their treatment regimens according to what they learned. 

"This trial was unique because patients acted as their own control. We compared progression-free survival after the patients progressed on their prior treatment regimen with what had occurred before molecular profiling," said Von Hoff. 

"This allowed us to control issues that confound other trials like tumour subtypes and differences in biology." 

Of the patients who were studied, 8 per cent had ovarian cancer, 17 per cent had colorectal cancer, 27 per cent had breast cancer and 48 per cent had cancers that were classified as miscellaneous. All these patients had progression of the tumour on prior chemotherapy regimens. 

After molecular profiling identified a precise target, a new treatment was suggested and there were noted improvements in progression-free survival for some patients. Among patients with ovarian cancer, the improvement in progression-free survival was 20 per cent; for colorectal, the improvement was 36 per cent; for breast, the improvement was 44 per cent; and for miscellaneous cancers the improvement was 16 per cent. 

Von Hoff said beyond progression-free survival, there were improvements in tumour size that were presented at the AACR Annual Meeting in Denver.

"With this trial, we are showing the power of personalised medicine using the tools we already have available to us. As these tools become more precise and more effective, the value of personalised medicine will increase," said Von Hoff.