According to newly published results in The Lancet Oncology, the implementation of a precision-medicine approach to therapy substantially prolonged survival rates for patients with pancreatic cancer compared with standard chemotherapy. According to researcher Michael Pishvaian, MD, PhD, associate professor in the Department of Oncology and director of the Gastrointestinal, Developmental Therapeutics, and Clinical Research Programs at Kimmel Cancer Center, Sibley Memorial Hospital, and Johns Hopkins University School of Medicine said, “Pancreatic cancer is a notoriously difficult disease to treat, and many of the promising therapies, including immunotherapy, have not yet made any impact on most patients with pancreatic cancer.” 

Dr. Pishvaian and colleagues investigated the effect of the Know Your Tumor (KYT) program on pancreatic-cancer treatment and outcomes in an estimated 1,856 patients to ascertain if molecularly matched therapy prolonged overall survival (OS) compared with unmatched therapy. The Pancreatic Cancer Action Network’s KYT program aids patients with pancreatic cancer throughout the United States to undergo multiomic profiling to offer molecular-tailored therapy options and clinical-trial recommendations. The median overall survival from diagnosis to advanced disease until death was the primary study endpoint.

The study researchers discovered actionable molecular alterations in 282 (26%) of 1,082 biopsy samples from patients registered in the KYT program who went through molecular testing. Among 677 patients with available outcomes, 189 had actionable molecular alterations. Median follow-up was 383 days (interquartile range, 214-588), and the results revealed that patients with actionable molecular alterations who obtained matched therapies (n = 46) achieved considerably longer median OS than patients who received unmatched therapies (n = 143; 2.58 years vs. 1.51 years; HR = 0.42; 95% CI, 0.26-0.68). 

In addition, the matched-therapy recipients also attained longer OS than 488 patients who did not have actionable molecular alterations (2.58 years vs. 1.32 years; HR = 0.34; 95% CI, 0.22-0.53). The researchers also reported no substantial difference in median OS between patients who received unmatched therapy and those without an actionable molecular alteration (HR = 0.82; 95% CI, 0.64-1.04). 

Dr. Pishvaian said, “The ability of patients with pancreatic cancer to undergo tumor molecular profiling or receive targeted therapies is a challenge in the U.S. health care system and—although about 25% of them have actionable alterations—less than 5% are able to receive targeted therapies because of either the aggressiveness of the disease or logistical and economic issues.” He added, “However, our results show that patients who have actionable molecular alterations can derive considerable benefit from receiving a matched therapy.”

The researchers wrote that these findings are crucial because they define an approximation of the current number of possibly actionable targets and a disappointing real-world evaluation of the number of patients who actually received molecularly targeted treatment.
 
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