Initiative for Molecular Profiling and Advanced Cancer Therapy (IMPACT): An MD Anderson precision medicine study.

Abstract

2513 Background: We present outcomes for 637 patients who were referred for phase I trials and were treated under IMPACT. Methods: Patients with advanced, refractory cancer who had tumor genomic analyses were treated with matched targeted therapy (MTT) when available. Results: Overall, 1,179 (82.1%) of 1,436 patients had ≥1 alteration (median age, 59.7 yrs; men, 41.2%); 637 had ≥1 actionable aberration and were treated with MTT (n=390) or non-MTT (n=247). Patients treated with MTT had higher rates of CR and PR (11% vs. 5%; p=.0099) (Table), longer failure-free survival (FFS) (3.4 vs. 2.9 months; p=.0015), and longer overall survival (OS) (8.4 vs. 7.3 months; p = .041) than unmatched patients. Two-month landmark analyses showed that, for MTT patients, FFS for responders vs. non-responders was 7.6 vs. 4.3 months (p<.0001) and OS was 23.4 vs. 8.5 months (p<.0001); for non-MTT patients (responders vs. non-responders), FFS was 6.6 vs. 4.1 months (p=.0005) and OS was 15.2 vs. 7.5 months (p = .43). Patients with both PI3K and MAPK pathway alterations matched to PI3K/Akt/mTor axis inhibitors alone showed outcomes comparable to unmatched patients. Conclusions: Matched versus unmatched patients had significantly better outcomes. For matched responders, median survival reached almost two years. However, matching patients who harbor both a PI3K and a MAPK pathway alteration to only a PI3K pathway inhibitor did not improve outcome. Clinical trial information: NCT00851032. [Table: see text]