A decision support system called GI TARGET may help integrate precision medicine into routine care for patients with gastrointestinal cancer, according to research published in JCO Precision Oncology.
GI TARGET offers oncologists “expert-led guidance on the interpretation and implementation” of tumor molecular profiling results, according to researchers.
In testing GI TARGET, the researchers found it was both scalable and sustainable. However, most of the oncologists studied did not follow GI TARGET recommendations.
The GI TARGET system involved a multidisciplinary team reviewing tumor molecular profiling results for patients with gastrointestinal cancers. Based on these results, the team recommended treatment or management strategies for these patients.
The team identified appropriate clinical trials using the computational matching platform MatchMiner, suggested targeted therapy options (on- or off-label), or recommended additional testing.
The researchers tested the GI TARGET system using genomic data from 542 patients with gastrointestinal cancers who underwent tumor molecular profiling with OncoPanel or other tests in the first 6 months of 2019.
The team provided summary reports of recommendations for 93% of patients (n=506). The patients had colorectal cancer (39%), pancreatic cancer (24%), esophagogastric cancer (13%), biliary tract cancer (8%), gastrointestinal neuroendocrine tumors (8%), and cancers of unknown primary (5%).
The reports were given to the 19 medical oncologists treating these patients. The reports recommended 1 or more precision medicine clinical trials for 80% of patients, and this led to 24 patients enrolling on trials.
The reports also recommended on-label targeted therapies for 6% of patients and off-label targeted therapies for 25%. Recommendations for additional or orthogonal molecular testing were made for 42% of patients.
Clinical data from the patients’ electronic health records were collected from June to November 2020 to assess the primary oncologists’ action on the basis of these recommendations.
The primary oncologists followed the recommendations for 16% of patients who had follow-up data. The researchers acknowledged that this result was modest, but they noted that “this number should be interpreted in the context of short follow-up and universal review of cases since the trigger for GI TARGET review is the release of OncoPanel results as opposed to a change in clinical status or provider request.”
“Our program adds value to OncoPanel and other tumor profiling through computationally driven clinical trial matching, multidisciplinary review of tumor genomics, and prioritization of therapeutic options,” the researchers concluded.
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Keller RB, Mazor T, Sholl L, et al. Programmatic precision oncology decision support for patients with gastrointestinal cancer.JCO Precis Oncol. Published online January 12, 2023. doi:10.1200/PO.22.00342