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    Home > Active Ingredient News > Antitumor Therapy > ASCO 2020- Precision Treatment of Childhood Oncology Gets New Boost! Priority algorithm is feasible

    ASCO 2020- Precision Treatment of Childhood Oncology Gets New Boost! Priority algorithm is feasible

    • Last Update: 2020-06-05
    • Source: Internet
    • Author: User
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    The 2020 Annual Meeting of the American Society of Clinical Oncology (ASCO) has begun, and this academic feast has won the attention of oncologists around the worldThe most-watched summary of the study ,Late-breaking Abstract , LBA , was officially released at 5 p.mEST on May 28 , with two entries for Oral Oral Session and five for LBA Plenasession SessionFollow in the footsteps of small editors and open the cloud year mode, and take a look at these heavyweight studiesthis issue is an LBA article selected for Oral Abstract Sessions, "The Study of Precision Oncology in Children: Clinical Results and the Benefits of Molecular Subgroup" (The Clinical Results and The Molecular Subgroup, abstract number LBA10503)1 ASCO 2020 selected LBA research (summary number: LBA10503, source: ASCO 2020 official website)research background
    precision medicine is constantly penetrating clinical practice, targeted therapy has great potential and plays a significant advantagePatients with difficult, relapsed, and high-risk childhood tumors often have poor prognosis, and some children's precision oncology programs have identified certain clinically-directed molecular variants, but the specific clinical benefits are unknown, Cornelis Martinus van Tilburg et alto assess the feasibility of pediatric precision oncology in the real world of clinical practice, carried out this INFORM studyThis summary reports on the current situation of precision oncology in children, and suggests that priority algorithms can identify targeted therapeutic beneficiariesFigure 2 Research Background (Source: ASCO 2020 official website)research methodsinform research is a forward-looking, non-intervention, multi-center, transnational feasibility registration study that collects clinical data and molecular data, including patients with refractory/recurrence/progressive malignant diseases, including high-risk objects initially diagnosedTake its fresh frozen tumor specimens( including mydagon DNA) forfull exon sequencing (whole-exosequencing, WES), low-coverage whole-genome sequencing (low-whole-whole-sequencing, lcWGS), RNA sequencing, RNA expression arrays, and DNA methylation analysisOnce a week, the Interdisciplinary Molecular Committee reviews and prioritizes variations based on the type of variation and its specific relevance to the individual, based on a seven-step scale from "very high" to "very low" (described in the 2016 journal of Miss et alin the journal Eur J Cancer)Figure 3 Research Methodology (Source: ASCO 2020)results
    to date, more than 1,300 patients have been selected525 patients from 72 centres in 8 countries were followed up and included in this analysisThe median age of the subjects was 12.0 years (0-40 years old) and the average turnaround time from submission to report was 25.4 daysMedian PFS and median OS are 116 days (95% CI 105 to 135) and 289 days (95% CI 250-335) days, respectivelyThe highest priority target distribution per patient was: very high 8.0%, high 14.8%, medium 20.3%, medium 23.6%, critical 14.4%, low 2.5%, very low 1.0%, no target 15.4% of clinical behaviorFigure 4 Diagnostic and Target Priority Distribution (Source: ASCO 2020 official website)149 patients received targeted treatment based on identified targets, of which 20 patients received median PFS of 204.5 (95% CI 91.0 to 628.0), while the median PFS in the other 505 patients was 114 days (95% CI 103 to 133) (P-0.0095)OS does not show clinically relevant differencesThe rate of disease progression time (TTP) before and after the exploratory analysis group showed that patients treated with a high priority target had a higher TTP ratio (1.0) than all other patients (0.7)Figure 5 Based on the PFS extension of patients who took the drug at very high priority targets (source: ASCO 2020 website) in addition, 7.8% of the patients in the study found possible susceptibility syndrome, half of which were newly diagnosed patients, and methylation analysis provided a precise diagnosis of 8% of central nervous system tumors Figure 6 Other results (source: ASCO 2020 official website) expand thinking
    this trial proves that children's precision oncology in the real world, multi-country background implementation is feasible Prioritization scales identify subgroups that benefit from molecular matching targeting therapy However, for patients without high-priority targets, further molecular and functional data layers should be incorporated into future plans a 2019 study published in JAMA has demonstrated whether genome sequencing can facilitate molecular spectrometry of patienttumors to identify actionable and targeted changes This forward-looking genome sequencing study (TRICEPS) in Quebec, Canada, included 62 subjects diagnosed with incurable or recurrent children and adolescents aged 18 or under between April 2014 and January 2018 cancer sin Figure 7 JAMA published study confirming the feasibility of genome sequencing (source: JAMA official website) the study performed WES and RNA sequence measurements on matching normal tumor specimens to determine single nucleotide variation, fusion transcription, differential gene expression, and copy number changes Through comprehensive molecular analysis, multimodal genome sequencing, including RNA sequencing, was found to be integrated into incurable or recurrent childhood and adolescent cancer management, and potential actionable changes were identified in 54 patients (87%) After identifying the actionable and targeted changes needed to treat these patients, a new treatment strategy with specifics and personalization was finally proposed study published in JAMA also confirms that it seems feasible to include genome sequencing in the treatment of difficult-to-treat childhood and adolescent cancers, molecular maps can identify potentially operational changes to clinical benefits for most patients, including targeted therapy and diagnosis, prognosis, and clinically relevant information monitoring children's cancer has its particularity, low incidence and limited clinical trial patients, but children's tumors have relatively few genetic mutations, so it can be seen that for children's tumors, in the era of precision medicine, gene therapy to help target the trend of treatment author: Tao Ran Source:
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