Data from the Paris-based Molecular Screening for Cancer Treatment Optimization (MOSCATO) trial demonstrates that establishing molecular portraits improves survival for patients with advanced cancer by tailoring treatment to their genetic makeup. The findings were presented at the Molecular Analysis for Personalised Therapy conference.
“This is the first demonstration that comprehensive genomic analysis could improve the clinical outcome for cancer patients,” stated Jean-Charles Soria, MD, PhD, principal investigator of the MOSCATO trial from the Gustave Roussy Cancer Campus in Paris.
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The trial’s primary objective was to demonstrate that incorporating high-throughput gene sequencing and using it to make therapeutic decisions could improve the clinical outcome for at least 25% of advanced/metastatic cancer patients. The trial enrolled 1100 patients with a wide range of solid tumors (lung, breast, head and neck, genitourinary, gastrointestinal, and a variety of rare cancers). The researchers identified 411 patients with an actionable target, and 199 were treated with an ad-hoc targeted therapy. To evaluate the clinical benefit of the targeted therapy, the patient was used as its own control. The progression-free survival (PFS) from the most recent therapy on which the patient had just experienced progression before enrollment in the trial was established for each patient. This PFS was compared with the PFS observed under the targeted therapy selected within the MOSCATO trial.
The researchers reported that 33% of patients had improved survival (at least a 30% increase of their PFS with ad-hoc targeted therapy compared with their baseline reference PFS). Furthermore, 62% of the patients had disease control (ie, objective response or stable disease).
“This positive result is particularly remarkable because the MOSCATO trial specifically excluded patients with well-established actionable targets for which approved and marketed targeted drugs are available (ie, lung cancer with EGFR mutation, or ALK translocation, BRAF mutant melanoma, GIST with KIT mutations, or breast cancer with HER2 amplification),” added Fabrice Andre, MD, PhD, head of the INSERM U981 research laboratory, and co-designer of the trial.
