NCI Pilot Trial to Assess Value of Genetic Sequencing for Improving Patient Outcomes
The National Cancer Institute (NCI) has launched a clinical trial to determine whether selecting therapies based on genetic mutations can improve outcomes in patients with metastatic solid tumors. Molecular Profiling based Assignment of Cancer Therapeutics (M-PACT) is one of the first randomized trials to assess if using genetic mutation as the basis for treatment selection can improve the rate and duration of response in patients with advanced-stage solid tumors.
A second goal is to see if the use of genetic sequencing can identify a subpopulation of patients who could benefit from specific targeted treatment, which would help to expedite drug development for these patients based on their genetic profile, and could lead to smaller clinical trials and reduce cost and time of drug development.
â€śPatients will have their tumors genetically screened, and if a predefined mutation is found, they will receive treatment with targeted agents,â€ť said Shivaani Kummar, MD, head of NCIâ€™s Developmental Therapeutics Clinic and the trialâ€™s principal investigator. â€śWhat we donâ€™t know, however, is whether using this approach to assign targeted treatments is really effective at providing clinical benefit to patients, as most tumors have multiple mutations, and itâ€™s not always clear which mutation to target and which agent is most likely to provide maximal benefit.â€ť
The M-PACT trial is designed to determine whether patients with mutations that have been shown in the laboratory to affect drug effectiveness will benefit from a specific targeted therapy, and if this approach results in better outcomes.
The NCI is now screening hundreds of people to select 180 patients with advanced refractory solid tumors based on their genetic profile. u
National Cancer Institute Press Release; January 30, 2014.
Mechanism of Pathway: Considerations of Cytogenetic and Molecular Mutation Status for Patients with Acute Myeloid Leukemia: A Deeper Look at the Role of Diagnostic and Ongoing Testing Across the Care Continuum
Acute myeloid leukemia (AML) is a heterogeneous disease that is characterized by uncontrolled proliferation of undifferentiated myeloid progenitors. While these leukemic blasts accumulate in the bone marrow and peripheral blood, impairment of normal hematopoiesis may lead to a reduction in the number of differentiated myeloid cells (granulocytes, neutrophils, monocytes, erythrocytes, megakaryocytes). Associated symptoms and consequences include anemia, bleeding, and an increased risk for infection.
Although the cost of care can have severe effects on patients with cancer and their families, oncologists rarely address financial toxicity, according to Hanna K. Sanoff, MD, MPH, Medical Director, University of North Carolina (UNC) NC Cancer Hospital Clinics.