Feasibility and value of genomic profiling in cancer of unknown primary: real-world evidence from prospective profiling study

Ryan W. Huey; Aakash Tushar Shah; Honey V. Reddi; Priyadarsini Dasari; James T. Topham; Hyunsoo Hwang; Nishat Dhillon; Anneleis Willett; Brandon G. Smaglo; Jeannelyn S. Estrella; Asif Rashid; Aurelio Matamoros; Michael J. Overman; Linda Choquette; Greg Omerza; Kevin Kelly; Xuemei Wang; Jonathan M. Loree; Jens Rueter; Gauri R. Varadhachary; Kanwal Raghav

doi:10.1093/jnci/djad095

Feasibility and value of genomic profiling in cancer of unknown primary: real-world evidence from prospective profiling study

Ryan W. Huey, Aakash Tushar Shah, Honey V. Reddi, Priyadarsini Dasari, James T. Topham, Hyunsoo Hwang, Nishat Dhillon, Anneleis Willett, Brandon G. Smaglo, Jeannelyn S. Estrella, Asif Rashid, Aurelio Matamoros, Michael J. Overman, Linda Choquette, Greg Omerza, Kevin Kelly, Xuemei Wang, Jonathan M. Loree, Jens Rueter, Gauri R. VaradhacharyKanwal Raghav

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Real-world evidence regarding the value of integrating genomic profiling (GP) in managing cancer of unknown primary (CUP) is limited. We assessed this clinical utility using a prospective trial of 158 patients with CUP (October 2016-September 2019) who underwent GP using next-generation sequencing designed to identify genomic alterations (GAs). Only 61 (38.6%) patients had sufficient tissue for successful profiling. GAs were seen in 55 (90.2%) patients of which GAs with US Food and Drug Administration-approved genomically matched therapy were seen in 25 (40.9%) patients. A change in therapy was recommended and implemented (primary endpoint of the study) in 16 (10.1%) and 4 (2.5%) patients of the entire study cohort, respectively. The most common reason for inability to implement the profiling-guided therapy was worsening of performance status (56.3%). Integrating GP in management of CUP is feasible but challenging because of paucity of tissue and aggressive natural history of the disease and requires innovative precision strategies.

Original language	English (US)
Pages (from-to)	994-997
Number of pages	4
Journal	Journal of the National Cancer Institute
Volume	115
Issue number	8
DOIs	https://doi.org/10.1093/jnci/djad095
State	Published - Aug 8 2023

ASJC Scopus subject areas

Oncology
Cancer Research

MD Anderson CCSG core facilities

Biostatistics Resource Group

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10.1093/jnci/djad095

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Huey, R. W., Shah, A. T., Reddi, H. V., Dasari, P., Topham, J. T., Hwang, H., Dhillon, N., Willett, A., Smaglo, B. G., Estrella, J. S., Rashid, A., Matamoros, A., Overman, M. J., Choquette, L., Omerza, G., Kelly, K., Wang, X., Loree, J. M., Rueter, J., ... Raghav, K. (2023). Feasibility and value of genomic profiling in cancer of unknown primary: real-world evidence from prospective profiling study. Journal of the National Cancer Institute, 115(8), 994-997. https://doi.org/10.1093/jnci/djad095

Huey, RW, Shah, AT, Reddi, HV, Dasari, P, Topham, JT, Hwang, H, Dhillon, N, Willett, A, Smaglo, BG , Estrella, JS , Rashid, A , Matamoros, A , Overman, MJ, Choquette, L, Omerza, G, Kelly, K, Wang, X, Loree, JM, Rueter, J, Varadhachary, GR & Raghav, K 2023, 'Feasibility and value of genomic profiling in cancer of unknown primary: real-world evidence from prospective profiling study', Journal of the National Cancer Institute, vol. 115, no. 8, pp. 994-997. https://doi.org/10.1093/jnci/djad095

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title = "Feasibility and value of genomic profiling in cancer of unknown primary: real-world evidence from prospective profiling study",

abstract = "Real-world evidence regarding the value of integrating genomic profiling (GP) in managing cancer of unknown primary (CUP) is limited. We assessed this clinical utility using a prospective trial of 158 patients with CUP (October 2016-September 2019) who underwent GP using next-generation sequencing designed to identify genomic alterations (GAs). Only 61 (38.6%) patients had sufficient tissue for successful profiling. GAs were seen in 55 (90.2%) patients of which GAs with US Food and Drug Administration-approved genomically matched therapy were seen in 25 (40.9%) patients. A change in therapy was recommended and implemented (primary endpoint of the study) in 16 (10.1%) and 4 (2.5%) patients of the entire study cohort, respectively. The most common reason for inability to implement the profiling-guided therapy was worsening of performance status (56.3%). Integrating GP in management of CUP is feasible but challenging because of paucity of tissue and aggressive natural history of the disease and requires innovative precision strategies.",

author = "Huey, {Ryan W.} and Shah, {Aakash Tushar} and Reddi, {Honey V.} and Priyadarsini Dasari and Topham, {James T.} and Hyunsoo Hwang and Nishat Dhillon and Anneleis Willett and Smaglo, {Brandon G.} and Estrella, {Jeannelyn S.} and Asif Rashid and Aurelio Matamoros and Overman, {Michael J.} and Linda Choquette and Greg Omerza and Kevin Kelly and Xuemei Wang and Loree, {Jonathan M.} and Jens Rueter and Varadhachary, {Gauri R.} and Kanwal Raghav",

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AU - Dasari, Priyadarsini

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AU - Dhillon, Nishat

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AU - Smaglo, Brandon G.

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AU - Rashid, Asif

AU - Matamoros, Aurelio

AU - Overman, Michael J.

AU - Choquette, Linda

AU - Omerza, Greg

AU - Kelly, Kevin

AU - Wang, Xuemei

AU - Loree, Jonathan M.

AU - Rueter, Jens

AU - Varadhachary, Gauri R.

AU - Raghav, Kanwal

PY - 2023/8/8

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N2 - Real-world evidence regarding the value of integrating genomic profiling (GP) in managing cancer of unknown primary (CUP) is limited. We assessed this clinical utility using a prospective trial of 158 patients with CUP (October 2016-September 2019) who underwent GP using next-generation sequencing designed to identify genomic alterations (GAs). Only 61 (38.6%) patients had sufficient tissue for successful profiling. GAs were seen in 55 (90.2%) patients of which GAs with US Food and Drug Administration-approved genomically matched therapy were seen in 25 (40.9%) patients. A change in therapy was recommended and implemented (primary endpoint of the study) in 16 (10.1%) and 4 (2.5%) patients of the entire study cohort, respectively. The most common reason for inability to implement the profiling-guided therapy was worsening of performance status (56.3%). Integrating GP in management of CUP is feasible but challenging because of paucity of tissue and aggressive natural history of the disease and requires innovative precision strategies.

AB - Real-world evidence regarding the value of integrating genomic profiling (GP) in managing cancer of unknown primary (CUP) is limited. We assessed this clinical utility using a prospective trial of 158 patients with CUP (October 2016-September 2019) who underwent GP using next-generation sequencing designed to identify genomic alterations (GAs). Only 61 (38.6%) patients had sufficient tissue for successful profiling. GAs were seen in 55 (90.2%) patients of which GAs with US Food and Drug Administration-approved genomically matched therapy were seen in 25 (40.9%) patients. A change in therapy was recommended and implemented (primary endpoint of the study) in 16 (10.1%) and 4 (2.5%) patients of the entire study cohort, respectively. The most common reason for inability to implement the profiling-guided therapy was worsening of performance status (56.3%). Integrating GP in management of CUP is feasible but challenging because of paucity of tissue and aggressive natural history of the disease and requires innovative precision strategies.

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Feasibility and value of genomic profiling in cancer of unknown primary: real-world evidence from prospective profiling study

Abstract

ASJC Scopus subject areas

MD Anderson CCSG core facilities

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