Clinical Trial Using Targeted Therapy “Doubled Survival” in Cancer Patients

Mesothelioma Help has reported countless times on the benefits of using a personalized treatment approach for mesothelioma patients. When the unique genetic makeup of a patient’s cancer is used to drive the therapy, survival and quality of life improve. Now, researchers report in a clinical trial that used tumor markers to determine the appropriate treatment for patients, regardless of cancer type, the treatment “slowed cancer growth and doubled survival.”

The IMPACT trial, touted as “the first and largest precision medicine trial to look at survival,” conducted by researchers from The University of Texas MD Anderson Cancer Center, enrolled 3,743 patients from 2007 to 2013, all with various types of end-stage cancers. The study, considered an “umbrella protocol” trial, was considered novel at the start because the researchers looked at tumor-specific gene mutations for trial selection, but did not look at “specific characteristics.”

“When we opened IMPACT, it was viewed as incredibly novel,” said Apostolia-Maria Tsimberidou, MD, PhD, of the MD Anderson Cancer Center in Houston. However, by using another targeted therapy trial as a guide, Tsimberidou said, “We hypothesized that genetic and molecular analysis of solid tumors also could enable the selection of optimal therapy for patients with solid tumors.”

Matched Targeted Therapy Can Improve Outcomes

The study compared treatment results of patients who received matched targeted therapy (MTT), i.e., the treatments were based on the biomarkers in their tumors, to those who received non-matched treatment (NMT).  The cancer types of patients included gastrointestinal, gynecologic, breast, melanoma, lung as well as incurable, rare cancers.

Mesothelioma, a rare form of cancer typically affecting the lining of the lungs, is highly aggressive and is resistant to many cancer treatments making it a difficult disease to treat effectively. Mesothelioma often evades even the strongest of drugs, but targeting those survival mechanisms can lead to effectively defeating the resistant cancer. Clinical trials are crucial for finding that  effective treatment.

The team found that the median progression-free and overall survivals for the MTT group were for 4 and 9.3 months, respectively,  compared to 2.8 months and 7.3 months to the NMT group. In addition, the three-year overall survival was 15 percent in MTT patients versus seven percent for the NMT patients. The 10-year survival was six percent for the MTT group compared to just one percent in the non-targeted treatment group.  The results were presented at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago last week.

“I am optimistic that in the next few years, we will dramatically improve outcomes for patients with cancer by increasing implementation of precision medicine,” said Tsimberidou, in a June 5 article in MedPage Today.
https://www.medpagetoday.com/meetingcoverage/asco/73291

“Ideally, in the future, patients’ tumor testing and cell-free DNA analysis will become the standard of care at the time of diagnosis, in hopes of making a difference for patients upfront, especially in those with hard-to-treat cancers,” said Tsimberidou.

Although the results for this study are positive, and precision medicine is being called “the wave of the future,”  Richard Schilsky, MD, ASCO chief medical officer urged caution saying the oncology community still has a lot to learn.

Personalized care targeted to a patient’s unique mesothelioma characteristics optimizes the potential for success of the treatment and offers treatment options that may not otherwise have been considered. Patient-centric therapy allows oncologists to select the right drug to home in on the specific biomarkers present in the mesothelioma cancer. The mesothelioma community closely follows personalized care breakthroughs in the hope that patients can experience long-term survival.

Mesothelioma patients are encouraged to discuss clinical trials, as an option for treatment, with their medical team,

Find out more about the IMPACT and the IMPACT 2 trial at ClinicalTrials.gov.

Sources:

• The University of Texas MD Anderson Cancer Center
  https://www.mdanderson.org/newsroom/2018/05/long-term-impact-data-find-improved-survival-when-targeted-therapies-matched-to-tumor-specific-gene-mutations.html
• IMPACT
  https://clinicaltrials.gov/ct2/show/NCT00851032
• IMPACT 2
  https://clinicaltrials.gov/ct2/show/NCT02152254