Sexual health in long-term breast cancer survivors |
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Authors: | Sara V. Soldera Marguerite Ennis Ana E. Lohmann Pamela J. Goodwin |
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Affiliation: | 1.Division of Medical Oncology and Hematology,Princess Margaret Cancer Centre,Toronto,Canada;2.Department of Medicine,University of Toronto,Toronto,Canada;3.Department of Oncology,National Taiwan University Hospital,Taipei,Taiwan;4.Laboratory Medicine Program,University Health Network,Toronto,Canada;5.Department of Laboratory Medicine and Pathobiology,University of Toronto,Toronto,Canada;6.Cancer Genomics Program,Princess Margaret Cancer Centre,Toronto,Canada;7.Department of Biostatistics,Princess Margaret Cancer Centre,Toronto,Canada;8.Department of Medical Biophysics,University of Toronto,Toronto,Canada;9.Division of Medical Oncology and Hematology,Sunnybrook Odette Cancer Centre,Toronto,Canada |
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Abstract: | PurposeNext-generation sequencing (NGS) has identified recurrent genomic alterations in metastatic breast cancer (MBC); however, the clinical utility of incorporating routine sequencing to guide treatment decisions in this setting is unclear. We examine the frequency of genomic alterations in MBC patients from academic and community hospitals and correlate with clinical outcomes.MethodsMBC patients with good performance status were prospectively recruited at the Princess Margaret Cancer Centre (PM) in Canada. Molecular profiling on DNA extracted from FFPE archival tissues was performed on the Sequenom MassArray platform or the TruSeq Amplicon Cancer Panel (TSACP) on the MiSeq platform. Clinical trial outcomes by RECIST 1.1 and time on treatment were reviewed retrospectively.ResultsFrom January 2012 to November 2015, 483 MBC patients were enrolled and 440 were genotyped. At least one somatic mutation was identified in 46% of patients, most commonly in PIK3CA (28%) or TP53 (13%). Of 203 patients with ≥ 1 mutation(s), 15% were treated on genotype-matched and 9% on non-matched trials. There was no significant difference for median time on treatment for patients treated on matched vs. non-matched therapies (3.6 vs. 3.8 months; p = 0.89).ConclusionsThis study provides real-world outcomes on hotspot genotyping and small targeted panel sequencing of MBC patients from academic and community settings. Few patients were matched to clinical trials with targeted therapies. More comprehensive profiling and improved access to clinical trials may increase therapeutic options for patients with actionable mutations. Further studies are needed to evaluate if this approach leads to improved clinical outcomes. |
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