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Abstract
Many patients with solid tumours are treated with targeted pharmacotherapy based on the results of genetic testing (‘precision medicine’). This study investigated the use of targeted drugs after OncoFOCUS™+KIT screening in patients with malignant melanoma, non-small cell lung cancer and metastatic colorectal cancer, and then audited the results against the National Comprehensive Cancer Network (NCCN) guidelines. Patients who were not indicated for targeted pharmacotherapy did not receive such treatment (99%, 100/101). Of the patients indicated for targeted drugs, 79% (33/42) received treatment according to NCCN guidelines. In 48% (20/42) of these patients the results from OncoFOCUS™+KIT screening were required for targeted drug selection. This study highlights the growing importance of precision medicine approaches in directing pharmacotherapy in medical oncology.
Highlights
Over the last 20 years the molecular profiles of many solid tumours have been characterised
The use of bevacizumab in metastatic colorectal cancer (mCRC) does not require genetic testing – it is considered equivalent to cetuximab and panitmumumab in RAS WT mCRC and was given first-line to most patients with mCRC at FCIC6
Targeted drugs for non-small cell lung cancer (NSCLC) and mCRC were subsidised by the Australian Pharmaceutical Benefits Scheme (PBS) in 2014 as second-line only
Summary
Over the last 20 years the molecular profiles of many solid tumours have been characterised. The discovery of specific variants in critical proteins that influence cancer pathogenesis has seen the development of ‘targeted pharmacotherapy’ – drugs that selectively inhibit unique molecular targets in tumour cells. Compared to traditional cytotoxic agents, targeted drugs have considerable benefits in the treatment of cancer, including improved response rates and less toxicity[1]. This field of cancer therapeutics is rapidly evolving with several hundred ongoing clinical trials. The NCCN guidelines are not always directly applicable for practice in Australia, these are reviewed annually, are freely available (www.nccn.org), and have best practice recommendations for targeted pharmacotherapy use in selected cancers
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