French researchers are taking advantage of the progress in genetic and molecular profiling to analyze the make-up of the tumors of individual cancer patients and then using the information to assign patients to particular treatments and phase I clinical trials. This “molecular triaging” approach could become part of everyday clinical practice.
The MOSCATO 01 trial (Molecular Screening for Cancer Treatment and Optimization) has enrolled more than 120 patients since it began in October 2011. Comparative genome hybridization (CGH) analyzes biopsy samples to identify changes in the DNA of the tumor, such as mutations, gene deletions, amplifications, or other molecular alterations. The results were made available within 3 weeks of a sample being taken. Then, an expert panel of scientists and clinicians reviewed the results to decide on the biological significance of the molecular changes and referred the patient to the relevant phase I trial where it was available.
More than 95% of the patients have agreed to join the MOSCATO trial, and molecular analysis was feasible in more than 85% of those patients. Molecular alterations were detected in half of the patients, and, so far, 30% of the patients have been allocated to a specific trial based on the molecular analysis.
“The most important findings at the moment are that this approach is feasible in the context of daily practice, and the patients are very keen to participate to this programme. A hundred patients were enrolled in seven months. They intuitively know that rational choice of their therapies is key to their future. For some patients, the results of the analyses changed the phase I trials and treatments for which they were being considered,” said Dr. Christophe Massard of the Institut Gustave Roussy in Villejuif, France.
This research was presented at the 24th EORTC-NCI-AACR Symposium on Molecular Targets and Cancer Therapeutics in Dublin, Ireland. The scientific chair of the Symposium, Professor Stefan Sleijfer, commented, “This study is interesting because it shows the feasibility of performing complex molecular characterization of tumors in daily clinical practice. Such approaches are key to reaching a more personalized treatment approach for cancer patients.”