1. Precision medicine and actionable alterations in lung cancer: A single institution experience
- Author
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Loretta Erhunmwunsee, Fang Qiu, Dan J. Raz, Marianna Koczywas, Isa Mambetsariev, Arya Amini, Sorena Nadaf, Lalit Vora, Jeremy Fricke, Surinder K. Batra, Lynette M. Smith, Janet Munu, Erminia Massarelli, Ravi Salgia, Rebecca Pharaon, Yingyu Wang, Chen Chen, Peiguo Chu, Jae Y. Kim, I. Amanam, Karen L. Reckamp, Andrea Bild, Raju Pillai, and Sagus Sampath
- Subjects
Male ,0301 basic medicine ,Lung Neoplasms ,Cancer Treatment ,Kaplan-Meier Estimate ,Lung and Intrathoracic Tumors ,Metastasis ,0302 clinical medicine ,Adenocarcinomas ,Basic Cancer Research ,Medicine and Health Sciences ,Anaplastic Lymphoma Kinase ,Registries ,Precision Medicine ,Aged, 80 and over ,Multidisciplinary ,Adenocarcinoma of the Lung ,Medical record ,Genomics ,Middle Aged ,3. Good health ,ErbB Receptors ,Oncology ,030220 oncology & carcinogenesis ,Cohort ,Medicine ,Female ,Research Article ,Adult ,Proto-Oncogene Proteins B-raf ,medicine.medical_specialty ,Science ,Adenocarcinoma ,Carcinomas ,Young Adult ,03 medical and health sciences ,Genomic Medicine ,Internal medicine ,Genetics ,medicine ,Adenocarcinoma of the lung ,Humans ,Lung cancer ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Proportional hazards model ,business.industry ,Genetic Variation ,Biology and Life Sciences ,Cancers and Neoplasms ,Computational Biology ,Retrospective cohort study ,Genome Analysis ,Genomic Libraries ,medicine.disease ,Precision medicine ,Clinical trial ,030104 developmental biology ,business - Abstract
ObjectivesOncology has become more reliant on new testing methods and a greater use of electronic medical records, which provide a plethora of information available to physicians and researchers. However, to take advantage of vital clinical and research data for precision medicine, we must initially make an effort to create an infrastructure for the collection, storage, and utilization of this information with uniquely designed disease-specific registries that could support the collection of a large number of patients.Materials and methodsIn this study, we perform an in-depth analysis of a series of lung adenocarcinoma patients (n = 415) with genomic and clinical data in a recently created thoracic patient registry.ResultsOf the 415 patients with lung adenocarcinoma, 59% (n = 245) were female; the median age was 64 (range, 22-92) years with a median OS of 33.29 months (95% CI, 29.77-39.48). The most common actionable alterations were identified in EGFR (n = 177/415 [42.7%]), ALK (n = 28/377 [7.4%]), and BRAF V600E (n = 7/288 [2.4%]). There was also a discernible difference in survival for 222 patients, who had an actionable alteration, with a median OS of 39.8 months as compared to 193 wild-type patients with a median OS of 26.0 months (PConclusionThe use of patient registries, focused genomic panels and the appropriate use of clinical guidelines in community and academic settings may influence cohort selection for clinical trials and improve survival outcomes.
- Published
- 2020
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