An improved personalized medicine network: The PLATON from GI and beyond

Personalized medicine aims to treat patients individually according to their biological and molecular features by directly targeting tumor-specific markers. Gastrointestinal cancers (GIC), despite different treatment strategies, still have a high recurrence and mortality rate. Like in all other cancers, different targeted therapies are also in clinical trials for GICs, but the monitorization of therapy success still needs improvement. The PLATON Network (PLATON, NCT05489250) is an interactive precision oncology network that aims to improve personalized medicine by interlinking scientists, allowing them to view/follow their patients’ clinical and molecular profiles and to recruit new patients for ongoing clinical trials and to implement substudies or to benefit from the BioDataBank within the Network. PLATON mostly covers GIC together with various tumor entities. PLATON can also be considered as an umbrella structure for subprojects, substudies and a screening tool for molecular-driven trials.

PLATON enrolls patients during or prior to first-line treatment and collects information on routine clinical data (baseline data, histopathology reports, treatment decisions, etc.). During follow-up, all anti-tumor therapy lines, tumor response, survival and quality of life data are recorded. Importantly, PLATON is able to offer molecular testing e.g. Foundation CDx and CDx Liquid and provide reports and molecular pathology case discussions by its own board of pathology experts. PLATON also enrolls cases with compatible external NGS reports through an evaluation by the central review board of medical advisors. PLATON is conducted by the Institute of Clinical Cancer Research (IKF) in Frankfurt.

In the PLATON network so far, a total of 217 patients (138 male (m) and 79 female (f)) with complete standardized data capture of NGS report results and clinical data are enrolled from 34 sites. The mean age is 64(m)/67(f) (min: 21(m)/24(f) and max: 88(m)/87(f)). Within the diagnostic cohorts, the GICs consist of 48 patients with esophagogastric cancer, 59 with intra-/extrahepatic cholangiocellular carcinoma additionally 17 patients with gallbladder carcinoma, 35 patients with hepatocellular cancer and 58 patients with pancreatic cancer. The individual observational status is ongoing in 112 out of 217 enrolled patients, while 92 died within 10 to 715 days after enrollment. Out of all cases, 143 were discussed in detail within the educational series of the PLATON project ”Molecular Pathology Case Discussion”. In total, 3070 genetic alterations were detected and 1817 of them were variants of unknown significance (VUS). A tumor mutational burden (TMB) over 10 up to 67 mutations/mb could be detected in 30 cases.

This study shows the feasibility of PLATON, especially for GIC. The obtained molecular results not only provide patient-specific therapy follow-up but also can provide baseline data for further projects and substudies. PLATON’s interactive, multicenter, prospective cohort provides a well-annotated and managed BioDataBank for translational research in GIs. PLATON aims to grow through prospective studies and is open to participation.

NCT05489250.

Institute of Clinical Cancer Research at Krankenhaus Nordwest.

Has not received any funding.

A. Vogel: Honoraria (self): AstraZeneca, Amgen, BeiGene, Böhringer Mannheim, BMS, BTG, Daichi-Sankyo, EISAI, GSK, Imaging Equipment Ltd (AAA), Incyte, Ipsen, Jiangsu Hengrui Medicines MSD, PierreFabre, Roche, Servier, Sirtex, Tahio, Terumo; Advisory / Consultancy: AstraZeneca, Amgen, BeiGene, Böhringer Mannheim, BMS, BTG, Daichi-Sankyo, EISAI, Incyte, Ipsen, MSD, PierreFabre, Roche, Servier, Sirtex, Tahio, Terumo. A. Reinacher-Schick: Honoraria (self): Amgen, Roche, Merck Serono, Bristol-Myers Squibb, MSD, MCI Group, AstraZeneca; Advisory / Consultancy: Amgen, Roche, Merck Serono, Bristol-Myers Squibb, MSD, AstraZeneca, Pierre Fabre; Research grant / Funding (institution): Roche, Celgene, Ipsen, Amgen, Alexion Pharmaceuticals, Astra Zeneca, Lilly, Servier, AIO Studien gGmbH, Rafael Pharmaceutics, Erytech Pharma, BioNTech; Travel / Accommodation / Expenses: Roche, Amgen, Pierre Fabre. A. Stein: Honoraria (Institution): Servier, Lilly; Research grant / Funding (institution): Servier. S. Al-Batran: Advisory / Consultancy: Bristol-Myers Squibb, Immutep, Lilly; MacroGenics; MSD Sharp & Dohme; Speaker Bureau / Expert testimony: AIO Studien gGmbH, Bristol-Myers Squibb, Lilly; MCI Deutschland GmbH; Research grant / Funding (institution): AstraZeneca; German Research Foundation; Hospira; Immutep; Roche, Bristol-Myers Squibb; German Cancer Aid (Krebshilfe); Ipsen; Lilly; MEDAC, Celgene; Eurozyto; Federal Ministry of Education and Research; MSD Sharp & Dohme; Sanofi; Vifor; Officer / Board of Directors: Institute of Clinical Cancer Research IKF at Northwest Hospital. All other authors have declared no conflicts of interest.