Next generation sequencing (NGS) may be highly beneficial in select patients with sarcoma, according to research reported at the Connective Tissue Oncology Society (CTOS) 2018 Annual Meeting in Rome, Italy. They found that NGS appears to provide benefits comparable to most US Food and Drug Administration (FDA)-approved second-line interventions.1 The authors reported that tumor profiling is most valuable when it is done early in the course of metastatic disease and if there is a molecular diagnostic question in the non-metastatic setting in patients with sarcoma.

The researchers reviewed the records of 33 patients treated at a single sarcoma clinic with FoundationOne testing. The researchers compared the fusion events with FISH results when available. They found that among the 33 patients, 31 could be included in a benefit analysis. The study showed that 90.9% of all the sarcomas surveyed (30/33 patients) had a therapeutic suggestion in the body of their charts. In addition, 42.4% had an available FDA approved targeted therapy in a different tumor type (14/33 patients).

The researchers found that 27 patients had measurable/unresectable disease and could be part of their efficacy review. Among those 27 patients, 40.7% received a therapy mentioned on their profile report (11/27 patients) and 4 patients had partial responses. The overall clinical benefit rate was found to be 18% (5/27).

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A patient with an NTRK fusion who received larotrectinib experienced an ongoing response for more than 2 years and a patient with chordoma also experienced a benefit after starting everolimus. The authors noted these findings are limited because of the small sample size and they called for a multiinstitutional collaboration to address this issue. Further, they have established a REDCap database, which is available for download to help link clinicians.               

Reference

  1. Victor A, Sahasrabudhe D, Baumgart M, et al. Utility of FoundationOne heme profiling in sarcoma: institutional experience and clinical outcomes. Presented at: CTOS 2018 Annual Meeting; Rome, Italy: November 14-17. Poster 188