Ezzeldin M. Ibrahim, Wesal M. Eldahna, Ahmed A. Refae, Ali M. Bayer,Osama A. Al-Masri, Rafat I. AbuShakra, Nasir A. Saleemand Ibrahim Mansoor
Journal Annals of Clinical Oncology (ISSN 2674-3248)
Background: Genomic tumor profiling is a novel technique that led to the identification of many genomic alterations in tumor tissues that could be exploited to deliver precise therapy to individual patient. Lack of data from Saudi Arabia about the utilization of that technology and its potential impact on clinical outcome has prompted this study.
Patients and Methods: Tumor tissues from 50 consecutive adult patients with metastatic solid cancer that is refractory to standard of care, were gnomically profiled.
Results: Patients’ median age was 56 years, and female constituted 76% of the series. All patients were heavily pretreated, with 52% having either breast, lung cancer, or ovarian cancer. In 88% of patients at least one genetic alteration was detected. Tumor profiling has guided the management decisions in 58%, 87%, and 14% of the overall patient population, breast cancer patients, and lung cancer patients, respectively. Meaningful disease response rates (complete remission, partial remission, and stable disease) were similar among those whose therapy decision was guided by tumor profiling (25 of 29 patients; 86%) and those where the therapy decision was not guided by the genomic findings (25 of 29 patients; 86% vs. 17 of 21 patients; 81%; P = 0.72). On the other hand, the median progression-free survival (PFS) determined from the time of making therapy decision based on the tumor profiling results was significantly longer among those whose management was supported by the findings (12.0 vs. 5.2 months, respectively; the hazard ratio and its 95% CI was 0.32 [0.13-0.81]; P = 0.017). While overall survival difference could not be estimated, the 12-months survival was 64% vs. 53% in the supported and the unsupported groups, respectively.
Conclusion: This preliminary experience demonstrated the feasibility and the clinical benefit of tumor profiling for cancer patients in Saudi Arabia. Tumor profiling is a promising novel technology; however, further research is required to address some of the inherent challenges to achieve the desired benefit.