Targeted therapy for intractable cancer on the basis of molecular profiles: An open-label, phase II basket trial (Long March Pathway)

Xiao-Dong Jiao, Bao-Dong Qin, Zhan Wang, Ke Liu, Ying Wu, Yan Ling, Wen-Xing Qin, Miao-Miao Wang, Ling-Wan Yuan, Savio Barreto, Anthony W. Kim, Kimberley Mak , Hao Li, Yuan-Yuan Xu, Xiao-Ming Qiu, Min Wu, Min Jin, Li-Chao Xu, Yi Zhong, Hui YangXue-Qin Chen, Yu Zeng, Jun Shi Shi , Wen-Yu Zhu, Qing-Qing Ding, Wei Jia, Su-Fen Liu, Jun-Jing Zhou, Hong Shen, Shi-Hua Yao, Zhao-Ji Guo, Ting Li, Pei-Juan Zhou, Xue-Wei Dong, Wen-Feng Lu, Robert L. Coleman, Mehmet Akce, Chérif Akladios, Francesco Puccetti, Yuan-Sheng Zang

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Abstract

Purpose: We evaluated he effects of molecular guided-targeted therapy for
intractable cancer. Also, the epidemiology of druggable gene alterations in
Chinese population was investigated.

Materials and methods: The Long March Pathway (ClinicalTrials.gov identifier:
NCT03239015) is a non-randomized, open-label, phase II trial consisting of several basket studies examining the molecular profiles of intractable cancers in the Chinese population. The trial aimed to 1) evaluate the efficacy of targeted
therapy for intractable cancer and 2) identify the molecular epidemiology of the
tier II gene alterations among Chinese pan-cancer patients.

Results: In the first stage, molecular profiles of 520 intractable pan-cancer patients were identified, and 115 patients were identified to have tier II gene alterations. Then, 27 of these 115 patients received targeted therapy based on molecular profiles. The overall response rate (ORR) was 29.6% (8/27), and the disease control rate (DCR) was 44.4% (12/27). The median duration of response (DOR) was 4.80 months (95% CI, 3.33−27.2), and median progression-free survival (PFS) was 4.67 months (95% CI, 2.33−9.50). In the second stage, molecular epidemiology of 17,841 Chinese pan-cancer patients demonstrated that the frequency of tier II gene alterations across cancer types is 17.7%. Bladder cancer had the most tier-II alterations (26.1%), followed by breast cancer (22.4%), and non-small cell lung cancer (NSCLC; 20.2%).

Conclusion: The Long March Pathway trial demonstrated a significant clinical
benefit for intractable cancer from molecular-guided targeted therapy in the
Chinese population. The frequency of tier II gene alterations across cancer types
supports the feasibility of molecular-guided targeted therapy under basket trials.
Original languageEnglish
Article number860711
Pages (from-to)1-11
Number of pages11
JournalFrontiers in Oncology
Volume13
DOIs
Publication statusPublished - 23 Feb 2023
Externally publishedYes

Keywords

  • Intractable Cancer
  • Basket Trial
  • Targeted Therapy
  • Gene Alteration
  • Precision Medicine

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