Genomic actionability and matched targeted therapy in a decade-long institutional precision medicine program for solid tumors

作者：Rodrigo Dienstmann, Ana Vivancos, Paolo Nucíforo, Sandra Ivette López Aguilar, Fiorella Ruíz‐Pace, Cristina Viaplana, José González, B Fite, Anna Pedrola, Elena Élez, Cristina Saura, Enriqueta Felip, Teresa Macarulla, Jaume Capdevila, Lorena Fariñas-Madrid, Joan Carles, Joaquı́n Mateo, Eva Muñoz‐Couselo, Judith Balmañà, Irene Braña, Elena Garralda, Josep Tabernero · 发表于：ESMO Open · 年份：2025 · DOI：10.1016/j.esmoop.2025.105888 · 被引用次数：2 · 研究领域：Cancer Genomics and Diagnostics、Lung Cancer Treatments and Mutations、PARP inhibition in cancer therapy

BACKGROUND: Precision oncology has evolved from concept to clinical reality, advancing cancer treatment and drug development in the last decade. However, disparities persist in patient access to comprehensive genomic profiling and matched therapies. MATERIALS AND METHODS: This was a retrospective analysis of all patients enrolled in the Vall d'Hebron Institute of Oncology (VHIO) precision medicine program (PMP) between 2014 and 2024. Tumor profiling outcomes were reviewed, focusing on actionable alterations, classified by the European Society for Medical Oncology Scale for Clinical Actionability of Molecular Targets (ESCAT). Interpretation and therapy prioritization were standardized through regular multidisciplinary molecular tumor boards. Key performance indicators (KPIs) included the proportions of patients with ESCAT tier I-IV alterations and those receiving matched therapies, either via clinical trials or approved regimens. The analysis also considered advances in molecular diagnostics, such as liquid biopsies, and the evolving clinical trial portfolio requiring biomarkers. RESULTS: From 2014 to 2024, 12 168 unique patients underwent 13 718 multi-gene molecular profiles at VHIO PMP. The detection rate of actionable alterations increased substantially over time, from 10.1% in 2014 to 53.1% in 2024, paralleling advances in drug biomarkers, sequencing technology, and broader use of assays. Overall, 10.1% of patients received molecularly matched therapies, rising from 1% in ...