Precision Medicine Tumor Boards: Clinical Applicability of Personalized Treatment Concepts in Ovarian Cancer

Abstract

Background: Treating cancer according to its molecular alterations (i.e., targeted treatment, TT) is the goal of precision medicine tumor boards (PTBs). Their clinical applicability has been evaluated for ovarian cancer patients in this analysis. Methods: All consecutive ovarian cancer patients discussed in a PTB at the Medical University of Vienna, Austria, from April 2015 to April 2019 were included (n = 44). Results: In 38/44 (86%) cases, at least one mutation, deletion or amplification was detected. The most frequently altered genes were p53 (64%), PI3K pathway (18%), KRAS (14%), BRCA1 (11%) and BRCA2 (2%). In 31 patients (70%) a TT was recommended. A total of 12/31 patients (39%) received the recommended therapy. Median time from indication for PTB to TT start was 65 days (15–216). Median time to treatment failure was 2.7 months (0.2–13.2). Clinical benefit rate (CBR) was 42%. Reasons for treatment discontinuation were disease progression (42%), poor performance status (PS > 2; 25%), death (17%) or treatment related side effects (8%). In 61% the TT was not administered—mainly due to PS > 2. Conclusion: Even though a TT recommendation can be derived frequently, clinical applicability remains limited due to poor patients’ general condition after exploitation of standard treatment. However, we observed antitumor activity in a substantial number of heavily pretreated patients.

PD-1 and PD-L1 expression on TILs in peritoneal metastases compared to ovarian tumor tissues and its associations with clinical outcome

“…Immunotherapies can significantly prolong survival of a portion of patients with solid tumors, particularly hypermutated cancers such as melanoma, renal cancer, and non-small cell lung cancer 1 – 3 . A variety of immunotherapies have been investigated over the years, and still, little is known on how to best match the most promising approach to each individual patient following the paradigm of Precision Medicine 4 . Currently, the therapeutic potential of immune checkpoint inhibitors is being investigated in numerous clinical trials not only in the recurrent setting but already in first line treatment of EOC patients (e.g.…”

Cancer Stemness Associated With Prognosis and the Efficacy of Immunotherapy in Adrenocortical Carcinoma

“…Although complete tumor resection accompanied with adjuvant mitotane therapy affords an opportunity to cure patients, the prognosis of adrenocortical carcinoma patients is generally poor with a median OS of around 15 months (5). Now, target immunotherapy has been successfully used in many kinds of cancers, such as breast cancer (6) and ovarian cancer (7), so it is necessary to make breakthroughs in ACC treatment. Now, research of cancer stem cells, which are defined as cells that have the characteristics of stem cells, the capacity of selfrenewal, and can promote tumor cells to invade and grow in cancer, has shown the unique function of cancer stem cells (8).…”

Stemness Related Genes Revealed by Network Analysis Associated With Tumor Immune Microenvironment and the Clinical Outcome in Lung Adenocarcinoma

“…Despite years of efforts to improve clinical outcomes with therapeutic strategies including surgery, radiotherapy, chemotherapy, immunotherapy, the prognosis is still less than satisfactory. Recently, targeted therapy based on its molecular alterations has been successfully applied to a variety of cancers, such as breast cancer (Xuhong et al, 2019), ovarian cancer (Aust et al, 2020), NSCLC (Santarpia et al, 2013), which encourages us to seek for more biomarkers that may serve as targeted agents.…”