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Article Dans Une Revue JCO precision oncology Année : 2022

Implementing the European Society for Medical Oncology Scale for Clinical Actionability of Molecular Targets in a Comprehensive Profiling Program: Impact on Precision Medicine Oncology

Patricia Martin-Romano
Laura Mezquita
  • Fonction : Auteur
Antoine Hollebecque
Ludovic Lacroix
Etienne Rouleau
  • Fonction : Auteur
Anas Gazzah
  • Fonction : Auteur
Rastilav Bahleda
  • Fonction : Auteur
David Planchard
Andrea Varga
Capucine Baldini
  • Fonction : Auteur
Sophie Postel-Vinay
Yohann Loriot
Loic Verlingue
Arthur Geraud
Maud Ngo Camus
  • Fonction : Auteur
Claudio Nicotra
  • Fonction : Auteur
Jean Charles Soria
  • Fonction : Auteur
Fabrice André
  • Fonction : Auteur
Benjamin Besse
Christophe Massard
Antoine Italiano

Résumé

PURPOSE To facilitate implementation of precision medicine in clinical management of cancer, the European Society of Medical Oncology proposed in 2018 a new scale to harmonize and standardize the reporting and interpretation of clinically relevant genomics data (ESMO Scale of Actionability of molecular Targets [ESCAT]). This study aims to characterize the clinical impact of matching targetable genomic alterations (GAs) in patients with advanced cancer according to ESCAT. MATERIAL AND METHODS Analysis of next-generation sequencing results from 552 patients is included in two prospective precision medicine studies at Gustave Roussy. End points included objective response rates, progression-free survival, and overall survival according to ESCAT. RESULTS Molecular data from 516 patients were available and discussed within a Molecular Tumor Board. The most common tumor types were GI (n = 164; 30%), lung (n = 137; 25%), and urologic tumors (n = 68; 13%). Overall, 379 GAs were considered as actionable targets according to ESCAT in 348 (67%) patients. In 31 (6%) patients, two concomitant actionable targets were identified. On the basis of ESCAT, GAs were considered to be classified as tier I in 120 patients (29%), II in 25 patients (5%), III in 80 patients (16%), and IV in 153 patients (30%). A total of 136 patients (27%) received a matched therapy. ESCAT was significantly associated with objective response rates and clinical benefit rates. The median progression-free survival was 6.5 months (95% CI, 4.2 to 8.9), 3 months (95% CI, 1 to not available), 3 months (95% CI, 2.2 to 3.8), and 4 months (95% CI, 2.8 to 6.3) for ESCAT I, II, III, and IV, respectively ( P = .0125). CONCLUSION Implementation of ESCAT classification for clinical decision making by Molecular Tumor Board is feasible and useful to better tailor therapies in patients with cancer.
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Dates et versions

hal-04633715 , version 1 (03-07-2024)

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Patricia Martin-Romano, Laura Mezquita, Antoine Hollebecque, Ludovic Lacroix, Etienne Rouleau, et al.. Implementing the European Society for Medical Oncology Scale for Clinical Actionability of Molecular Targets in a Comprehensive Profiling Program: Impact on Precision Medicine Oncology. JCO precision oncology, 2022, 6, ⟨10.1200/PO.21.00484⟩. ⟨hal-04633715⟩
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