In a new treatment course for cancer, personalised, combination therapies were found to improve outcomes in patients with therapy-resistant tumours. Patients treated by University of California San Diego (UCSD) researchers were considered highly matched when more than 50% of their tumour mutations matched to drugs – at least 50% were then more responsive to treatment.

According to first author and co-principal investigator Jason K. Sicklick, MD, Associate Professor of Surgery and Surgical Oncologist at UCSD, amulti-specialty team of oncology experts overcame single-alteration mutations in patients by formulating a specific therapy which resulted in an increased response rate and improved overall and progression-free survival in patients who were highly matched to treatment versus those who were unmatched or less well-matched.

The I-PREDICT navigation trial enrolled patients at either Moores Cancer Centreor Avera Cancer Institute in South Dakota, US; of 149 participants with metastatic, treatment-refractory disease, 73 were matched to a therapy, 66 were untreated because their disease progressed too rapidly or had died, and 10 had completely unmatched treatment.

Genomic data using next generation sequencing technology was gathered for each patient and presented to a molecular tumour board that created custom, multidrug combinations to target a majority of the genomic alterations in each patient’s tumors. The therapies were administered based on the treating oncologists’ choice and individual patient’s preference. The drugs included gene product-targeted drugs, hormone therapies, immunotherapies and chemotherapies. Patient outcomes were also monitored extensively.

Shumei Kato, MD and Assistant Professor of Medicine at UCSD School of Medicine, has said that the 50% match percentage was much higher than most precision medicine studies because of the immediate review of genomic results by the board and navigators who helped patients and physicians access clinical trials and off-label FDA-approved drugs.

Sicklick has added that personalised combinations are vital since no two tumors or regimens will be exactly the same. UCSD’s findings demonstrate a feasible and safe approach as patients are monitored closely and started on reduced doses.

While researchers concede that larger follow-up studies are needed to confirm the findings, senior author and co-principal investigator Razelle Kurzrock, MD, Director of the Centre for Personalised Cancer Therapy at Moores Cancer Centre highlights the importance of personalised, precision medicine combination approaches, to determine its benefits if the strategy is instituted earlier in disease progression.