Molecular Profiling-Selected Therapy for Treatment of Advanced Pancreaticobiliary Cancer: A Retrospective Multicenter Study

• Published in: BioMed research international Vol. 2015; no. 2015; pp. 1 - 9
• Main Authors: Hubert, Ayala, Purim, Ofer, Temper, Mark, Voss, Andreas, Russell, Kenneth, Dvir, Addie, Soussan-Gutman, Lior, Stemmer, Salomon M., Geva, Ravit, Golan, Talia, Gez, Eliahu, Brenner, Ronen, Brenner, Baruch, Agbarya, Abed, Klein, Baruch, Shacham-Shmueli, Einat, Epelbaum, Ron, Tepper, Ella
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Publishing Corporation 01-01-2015; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: Adult; Aged; Aged, 80 and over; Bile Duct Neoplasms - drug therapy; Bile Duct Neoplasms - metabolism; Bile Duct Neoplasms - pathology; Biomarkers; Biomarkers, Tumor - metabolism; Biopsy; Cancer; Cancer therapies; Care and treatment; Disease-Free Survival; Female; Gene expression; Hospitals; Humans; Life sciences; Male; Medical treatment; Metastasis; Middle Aged; Neoplasm Staging; Oncology; Pancreatic cancer; Pancreatic Neoplasms - drug therapy; Pancreatic Neoplasms - metabolism; Pancreatic Neoplasms - pathology; Pharmaceuticals; Physiological aspects; Rare diseases; Retrospective Studies; Studies; Tomography; Tumors
• ISSN: 2314-6133; 2314-6141
• DOI: 10.1155/2015/681653

This multicenter cohort study assessed the impact of molecular profiling (MP) on advanced pancreaticobiliary cancer (PBC). The study included 30 patients treated with MP-guided therapy after failing ≥1 therapy for advanced PBC. Treatment was considered as having benefit for the patient if the ratio between the longest progression-free survival (PFS) on MP-guided therapy and the PFS on the last therapy before MP was ≥1.3. The null hypothesis was that ≤15% of patients gain such benefit. Overall, ≥1 actionable (i.e., predictive of response to specific therapies) biomarker was identified/patient. Immunohistochemistry (the most commonly used method for guiding treatment decisions) identified 1–6 (median: 4) actionable biomarkers per patient. After MP, patients received 1–4 (median: 1) regimens/patient (most commonly, FOLFIRI/XELIRI). In a decision-impact analysis, of the 27 patients for whom treatment decisions before MP were available, 74.1% experienced a treatment decision change in the first line after MP. Twenty-four patients were evaluable for clinical outcome analysis; in 37.5%, the PFS ratio was ≥1.3. In one-sided exact binomial test versus the null hypothesis, P = 0.0015; therefore, the null hypothesis was rejected. In conclusion, our analysis demonstrated the feasibility, clinical decision impact, and potential clinical benefits of MP-guided therapy in advanced PBC.