Molecularly matched treatment for Pancreatic cancer

Molecular profiling is emerging as a part of standard treatment to identify targetable abnormalities in patients with pancreatic cancer. To further assess the benefit of this approach, investigators conducted the industry-sponsored Know Your Tumour registry trial, in which patients with pancreatic cancer underwent commercially available genomic profiling and were followed for treatment outcome.

Of 1,082 patients who received genomic profiling reports, 677 had follow-up for treatment and overall survival (OS). Of these patients, 189 (28%) had actionable mutations, of whom 46 (24%) received target-matched treatment and 143 (76%) received unmatched treatment. OS was superior for the actionable patients receiving matched versus unmatched therapy (2.58 vs. 1.51 years; hazard ratio, 0.42; P=0.0004). OS was similar between unmatched targetable patients and nontargetable patients (1.32 years).  This prospective trial evaluating the use of genomic profiling in pancreatic cancer indicates a potential survival benefit if eligible patients receive target-directed therapy. However, only 2% of all patients enrolled received matched therapy, introducing the possible risk of patient selection bias.