Title :

Genomics to select treatment for patients with metastatic breast cancer.

Author(s) :

Andre, F. [Auteur]
Institut Gustave Roussy [IGR]
Biomarqueurs prédictifs et nouvelles stratégies moléculaires en thérapeutique anticancéreuse [U981]
Filleron, T. [Auteur]
Institut Claudius Regaud [ICR]
Kamal, M. [Auteur]
Institut Curie - Saint Cloud [ICSC]
Mosele, F. [Auteur]
Institut Gustave Roussy [IGR]
Biomarqueurs prédictifs et nouvelles stratégies moléculaires en thérapeutique anticancéreuse [U981]
Arnedos, M. [Auteur]
Institut Gustave Roussy [IGR]
Dalenc, Florence [Auteur]
Institut Claudius Regaud [ICR]
Sablin, M. P. [Auteur]
Campone, M. [Auteur]
Institut de Cancérologie de l'Ouest [Angers/Nantes] [UNICANCER/ICO]
Bonnefoi, H. [Auteur]
Institut Bergonié [Bordeaux]
Lefeuvre-Plesse, Claudia [Auteur]
CRLCC Eugène Marquis [CRLCC]
Jacot, William [Auteur]
Institut de Recherche en Cancérologie de Montpellier [IRCM - U1194 Inserm - UM]
Coussy, F. [Auteur]
Ferrero, J. M. [Auteur]
Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] [UNICANCER/CAL]
Emile, G. [Auteur]
Mouret-Reynier, Marie Ange [Auteur]
Centre Jean Perrin [Clermont-Ferrand] [UNICANCER/CJP]
Thery, J. C. [Auteur]
Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen [CLCC Henri Becquerel]
Isambert, Nicolas [Auteur]
Département d'oncologie médicale [Centre Georges-François Leclerc]
Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] [UNICANCER/CRLCC-CGFL]
Mege, A. [Auteur]
Institut Sainte Catherine [Avignon]
Barthelemy, Philippe [Auteur]
Institut de Cancérologie de Strasbourg Europe [ICANS]
You, B. [Auteur]
Université Claude Bernard Lyon 1 [UCBL]
Hajjaji, Nawale [Auteur]
Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192
Lacroix, L. [Auteur]
Rouleau, E. [Auteur]
Tran-Dien, A. [Auteur]
Boyault, S. [Auteur]
Attignon, V. [Auteur]
Centre Léon Bérard [Lyon]
Gestraud, Pierre [Auteur]
Mines Paris - PSL (École nationale supérieure des mines de Paris)
Servant, N. [Auteur]
Le Tourneau, C. [Auteur]
Cherif, L. L. [Auteur]
Soubeyran, I. [Auteur]
Montemurro, F. [Auteur]
Morel, A. [Auteur]
CRLCC - Centre Paul Papin [CRLCC Paul Papin]
Lusque, A. [Auteur]
Institut Claudius Regaud [ICR]
Jimenez, M. [Auteur]
Jacquet, A. [Auteur]
Gonçalves, A. [Auteur]
Bachelot, T. [Auteur]
Bieche, I. [Auteur]
Institut Cochin [IC UM3 (UMR 8104 / U1016)]
Institut Curie [Paris]

Journal title :

Nature

Abbreviated title :

Nature

Publication date :

2022-09-10

ISSN :

1476-4687

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Cancer progression is driven in part by genomic alterations1. The genomic characterization of cancers has shown interpatient heterogeneity regarding driver alterations2, leading to the concept that generation of genomic ...
Show more >Cancer progression is driven in part by genomic alterations1. The genomic characterization of cancers has shown interpatient heterogeneity regarding driver alterations2, leading to the concept that generation of genomic profiling in patients with cancer could allow the selection of effective therapies3,4. Although DNA sequencing has been implemented in practice, it remains unclear how to use its results. A total of 1,462 patients with HER2-non-overexpressing metastatic breast cancer were enroled to receive genomic profiling in the SAFIR02-BREAST trial. Two hundred and thirty-eight of these patients were randomized in two trials (nos. NCT02299999 and NCT03386162) comparing the efficacy of maintenance treatment5 with a targeted therapy matched to genomic alteration. Targeted therapies matched to genomics improves progression-free survival when genomic alterations are classified as level I/II according to the ESMO Scale for Clinical Actionability of Molecular Targets (ESCAT)6 (adjusted hazards ratio (HR): 0.41, 90% confidence interval (CI): 0.27–0.61, P < 0.001), but not when alterations are unselected using ESCAT (adjusted HR: 0.77, 95% CI: 0.56–1.06, P = 0.109). No improvement in progression-free survival was observed in the targeted therapies arm (unadjusted HR: 1.15, 95% CI: 0.76–1.75) for patients presenting with ESCAT alteration beyond level I/II. Patients with germline BRCA1/2 mutations (n = 49) derived high benefit from olaparib (gBRCA1: HR = 0.36, 90% CI: 0.14–0.89; gBRCA2: HR = 0.37, 90% CI: 0.17–0.78). This trial provides evidence that the treatment decision led by genomics should be driven by a framework of target actionability in patients with metastatic breast cancer.Show less >

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192

Submission date :

2023-12-13T04:07:31Z
2024-01-31T16:26:59Z