Abstract LB-040: Application of clinical whole exome sequencing among larger scale advanced cancer patients in China

Abstract

Abstract Background: Genomics-guided precision medicine has become a major paradigm shifting effort in cancer care globally to improve the outcome of cancer patients. More and more patients receive individualized cancer treatments based on their tumor-specific characteristics at both gene and genomic levels. Methods: Over 1,000 cancer patients from more than 70 hospitals across 20 provinces in China were recruited into the project. Majority (88%) of these patients are with 4 major tumor types, which are lung, gastric, colorectal, and breast cancer. The whole exome of tumor specimen and case-matched normal samples were sequenced in each patient. Clinical decision roadmap recommendations were provided to each patient and their treating physician based on clinical whole exome sequencing (CWES) and globally available treatment options. The treatment implementation and the outcome of each patient have been followed. Results: Of the 907 prospectively enrolled patients, 80% patients was recommended at least one FDA approved target/immunotherapy drug. 60% patients’ tumors have cancer driver/suppressor gene large segment deletions or amplifications. At the end of December 2016, 98 patients with late stage NSCLC, breast or colorectal cancer had more than 6 months follow up. Ninety five percent of (93) patients received personalized target/immunotherapy recommendations based on CWES, including genomic-matched clinical trials. Thirty percent (29) patients actually received the recommended therapy clinically. Of those 29 patients, 55% (16) patients received the treatments recommended by CWES. And 14 of those 16 patients had stable disease (SD) at the time of this report. 25 patients initially received treatment based on other panel-based recommendations, and 14 of the 25 patients suffered disease progression. Among those 14 patients, 8 patients received recommended treatment based on CWES and achieved SD at a later time. Conclusions: CWES can provide clinical relevant treatment recommendations for most of the advanced cancer patients. Our preliminary observations suggests that CWES might provide a boarder clinical recommendation roadmap for the cancer patients in China. Longer follow-up is needed to evaluate the clinical significance of CWES on long term prognosis. Citation Format: Qiang Xu, Guan Wang, Chun Dai, Cheng Chen, Xiaoman Xu, Haining Wang, Angela Wu, Jiping Wang. Application of clinical whole exome sequencing among larger scale advanced cancer patients in China [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr LB-040. doi:10.1158/1538-7445.AM2017-LB-040