A pilot study utilizing multi-omic molecular profiling to find potential targets and select individualized treatments for patients with previously treated metastatic breast cancer

作者：Jameson Gayle S^*; Petricoin Emanuel F; Sachdev Jasgit; Liotta Lance A; Loesch David M; Anthony Stephen P; Chadha Manpreet K; Wulfkuhle Julia D; Gallagher Rosa I; Reeder Kimberley A; Pierobon Mariaelena; Fulk Monica R; Cantafio Nina A; Dunetz Bryant; Mikrut William D; Von Hoff Daniel D; Robert Nicholas J

来源：Breast Cancer Research and Treatment, 2014, 147(3): 579-588.

DOI：10.1007/s10549-014-3117-1

• Individualized treatment
• Metastatic breast cancer
• Translational research
• Translational oncology
• Molecular profiling
• Multi-omic profiling
• Reverse phase protein array (RPPA)

The primary objective was to determine if multi-omic molecular profiling (MMP) informed selection of approved cancer treatments could change the clinical course of disease for patients with previously treated metastatic breast cancer (MBC) (i.e., produce a growth modulation index (GMI) a parts per thousand yen1.3). GMI was calculated as the ratio of progression free survival on MMP-selected therapy/time to progression on last prior treatment. To meet the primary objective at least 35 % of the subjects should demonstrate a GMI a parts per thousand yen1.3. Secondary endpoints included determining the response rate (according to RECIST 1.1), the percent of patients with non-progression at 4 months, and overall survival in patients whose therapy is selected by molecular profiling and proteomic analysis. Eligible patients had MBC, with a parts per thousand yen3 prior lines of therapy. A multi-omic based approach was performed incorporating multiplexed immunohistochemistry, c-DNA microarray, and phosphoprotein pathway activation mapping by reverse phase protein array. MMP was performed on fresh core biopsies; results were generated and sent to a Treatment Selection Committee (TSC) for review and treatment selection. Three sites enrolled 28 patients, of which 25 were evaluable. The median range of prior treatment was 7 (range 3-12). The MMP analysis and treatment recommendation were delivered within a median of 15.5 days from biopsy (range 12-23). The TSC selected MMP-rationalized treatment in 100 % (25/25) of cases. None of the MMP-based therapies were the same as what the clinician would have selected if the MMP had not been performed. GMI a parts per thousand yen1.3 was reported in 11/25 (44 %) patients. Partial responses were noted in 5/25 (20 %), stable disease in 8/25 (32 %) and 9/25 (36 %) had no progression at 4 months. This pilot study demonstrates the feasibility of finding possible treatments for patients with previously treated MBC using a multiplexed MMP-rationalized treatment recommendation. This MMP approach merits further investigation.

• 出版日期2014-10