Abstract
BackgroundThe use of Next-Generation Sequencing (NGS) has recently allowed significant improvements in cancer treatment. Foundation Medicine® (FM) provides a genomic profiling test based on NGS for a variety of cancers. However, it is unclear if the Foundation Medicine test would result in a better outcome than the standard on-site molecular testing. In this retrospective chart review, we identified the FM cases from an academic Canadian hospital and determined whether these test results improved treatment options for those patients.Materials and MethodsA retrospective analysis was performed on patients with solid tumors who had FM testing between May 1, 2014 and May 1, 2018. Clinical factors and outcomes were measured using descriptive statistics using Microsoft Excel® Software.ResultsOut of 66 FM tests, eight patients (= 12%) had a direct change in therapy based on the FM tests. Identified were 285 oncogenic mutations (median 1, range 0–31); where TP53 (n = 31, 10.9%), CDKN2A (n = 19, 6.7%), KRAS (n = 16, 5.6%) and APC (n = 9, 3.2%) were the most common FM mutations identified.ConclusionA small proportion of FM reports identified actionable mutations and led to direct treatment change. FM testing is expensive and a few of the identified mutations are now part of routine on-site testing. NGS testing is likely to become more widespread, but this research suggests that its true clinical impact may be restricted to a minority of patients.
Highlights
Precision medicine, known as targeted medicine/genomic medicine or personalized medicine, is increasingly important in the management of cancers [1]
Our study showed a median age of patients to be 56 years, which is similar to a study on hematological cancers sent for comprehensive genetic profiling, whom had a mean age of 54 years [10] but slightly dissimilar to the median age of 62 years found in patients with advanced solid tumors sent for FoundationOne CDx panel [18]
This study focused on the demographics of the patients sent for Foundation Medicine® testing, and their mutations found, as well as the treatment given based on this, and overall survival of all patients
Summary
Known as targeted medicine/genomic medicine or personalized medicine, is increasingly important in the management of cancers [1]. More information for the patient and clinician may help with prognostication, identification of a clinical trial or even a rare but available therapy [7] These tests can be expensive, not yield useful information, or potentially yield a useful answer that is unable to be acted on [7]. Foundation Medicine® (FM) provides a genomic profiling test based on NGS for a variety of cancers It is unclear if the Foundation Medicine test would result in a better outcome than the standard on-site molecular testing. In this retrospective chart review, we identified the FM cases from an academic Canadian hospital and determined whether these test results improved treatment options for those patients
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