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The impact of tumor molecular profile-directed treatment on survival in recurrent ovarian cancer.
Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^).
Background: We sought to determine whether tumor molecular profile-directed treatment of recurrent ovarian, primary peritoneal and fallopian tube carcinomas influenced survival. Methods: With IRB approval, Caris Life Sciences, Ltd maintains the Caris Registry, a database of clinicopathologic and outcome variables from consenting patients whose tumors underwent molecular profiling. Molecular profiling was performed using a multiplatform approach to stratify agents by degree of potential therapeutic benefit. The Caris Registry was queried for all patients with a diagnosis of ovarian, primary peritoneal and fallopian tube carcinomas enrolled between 2010 and 2014. Patients were stratified based on chemotherapeutic agents employed during their disease course: the molecularly-guided (MG) cohort received at least one agent designated to be of potential benefit and no agents with potential lack of benefit while the non-molecularly-guided cohort (non-MG) received at least one agent with potential lack of benefit. Survival was calculated from the date of profiling and from the date of diagnosis to the date of death/censoring using the Kaplan-Meier method. Results: Of 445 patients identified in the registry, 90 were excluded due to non-invasive pathology, non-epithelial histology, and missing or ambiguous treatment information. Of the remaining 355 eligible and evaluable patients, 166 formed the MG cohort and the remaining 189 were assigned to the non-MG cohort. There were no significant differences in baseline clinicopathologic characteristics between the two groups. Patients in the MG cohort experienced significantly longer post-profiling survival when compared with patients in the non-MG cohort, HR 0.64 (CI 0.41 – 0.97, p = 0.03). Additionally, there was a trend toward longer overall survival in the MG cohort. Conclusions: Tumor molecular profile-directed treatment significantly improves post-profiling survival in patients with recurrent ovarian, primary peritoneal and fallopian tube carcinomas. Despite immature outcome data, trends toward improved overall survival were also demonstrated.