Genomic profiling helps provide targeted therapy options for hard to treat cancers

Genomic alterations affecting the P13K/AKT/mTOR pathway are commonly seen among various cancer types (Kandoth, 2013). Through this research, Rutgers Cancer Institute investigators wanted to determine how comprehensive genomic profiling could be used in clinical care to identify alterations affecting this pathway.

Utilizing tumors from a genomic analysis clinical trial at Rutgers Cancer Institute examining rare cancers and those that respond poorly to standard care, 97 tumors with the P13K/AKT/mTOR pathway were profiled. Genomic alterations were reviewed by the Institute's molecular tumor board and recommendations for patient treatment options were made regarding genomically targeted therapies either already approved or used investigationally -- including clinical trials.

Out of the 97 cases, 33 adult patients received therapy targeting the P13K/AKT/mTOR pathway. Tumors tested included gynecologic, renal, sarcomas, pancreatic, melanoma, T cell lymphoma, bladder and adrenal. Outcomes were available for 19 of the 33 cases. A clinical benefit or improved patient outcome of three to eight months was seen in seven of the 19 patients (37 percent) who received drugs targeting this pathway. The response was not specific to tumor type.

"We are re-defining cancer classification," notes Rutgers Cancer Institute Precision Medicine Director Lorna Rodriguez, MD, PhD, who is the senior investigator of the work. "Instead of focusing on where the cancer first originated, we now have an ability to drill down and further examine and identify potentially actionable genomic features within the tumor. This not only enables clinicians to rapidly employ tailored treatment strategies, but also provides for the development of future therapies in the form of new clinical trials," adds Dr. Rodriguez, who is also a professor of obstetrics, gynecology and reproductive sciences at Rutgers Robert Wood Johnson Medical School.