24 March 2022

Genomic sequencing of tumours from child patients suffering relapse can often point to therapies that would not otherwise be considered, French researchers have reported.

Children with leukaemias and lymphomas were among the patients from France, Italy, Ireland, and Spain who took part in the MAPPYACTS study.

Of the 774 patients who donated samples, 632 had successful genomic sequencing. Based on the sequencing findings, researchers identify 432 patients with “potentially actionable” mutations.

Of these, 107 were matched with a targeted therapy, including one patient with T-cell acute lymphoblastic leukaemia. 44 of these treatments were consider “ready for routine use”, backed by the highest level of evidence. Notably, 42% of these “ready for routine use” alterations were previously unknown or had not been identified by previous diagnostics.

The remainder had treatments considered “investigational” or “hypothetical”, with lower levels of evidence available.

The overall response rate of patients who received a matched therapy was 17%. Among patients who received treatments classified as “ready for routine use”, there was a response rate of 38%.

The findings were published in the journal Cancer Discovery. The project is to continue in the AcSé-ESMART trial and the upcoming MAPPYACTS 2 trial.

Professor Birgit Geoerger, one of the senior authors of the study, said: “The main purpose was to genetically profile the patients’ tumours and use that to suggest a treatment. Are there molecular alterations that we can target with these newer drugs?”

Professor Geoerger added: “Our recommendation would be to have a sequencing panel for the ‘ready for routine use’ mutations and fusions. Nearly everybody should have that as part of their diagnostic setup.”

Source: Berlanga P, Pierron G, Lacroix L, Chicard M, Adam de Beaumais T, Marchais A, Harttrampf AC, Iddir Y, Larive A, Soriano Fernandez A, Hezam I, Chevassus C, Bernard V, Cotteret S, Scoazec JY, Gauthier A, Abbou S, Corradini N, Andre N, Aerts I, Thebaud E, Casanova M, Owens C, Hladun-Alvaro R, Michiels S, Delattre O, Vassal G, Schleiermacher G, Geoerger B. (2022) “The European MAPPYACTS trial: Precision Medicine Program in Pediatric and Adolescent Patients with Recurrent Malignancies.” Cancer Discovery, doi: 10.1158/2159-8290.cd-21-1136

Link: https://aacrjournals.org/cancerdiscovery/article/doi/10.1158/2159-8290.CD-21-1136/682155/The-European-MAPPYACTS-trial-Precision-Medicine

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