Application of molecular profiling in clinical trials for advanced metastatic cancers

Shivaani Kummar, P. Mickey Williams, Chih Jian Lih, Eric Polley, Alice P. Chen, Larry V. Rubinstein, Yingdong Zhao, Richard M. Simon, Barbara A. Conley, James H. Doroshow

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

There is growing interest in the application of molecular profiling, including sequencing, genotyping, and/or mRNA expression profiling, to the analysis of patient tumors with the objective of applying these data to inform therapeutic choices for patients with advanced cancers. Multiple clinical trials that are attempting to validate this personalized or precision medicine approach are in various stages of development and execution. Although preliminary data from some of these efforts have fueled excitement about the value and utility of these studies, their execution has also provoked many questions about the best way to approach complicating factors such as tumor heterogeneity and the choice of which genetic mutations to target. This commentary highlights some of the challenges confronting the clinical application of molecular tumor profiling and the various trial designs being utilized to address these challenges. Randomized trials that rigorously test patient response to molecularly targeted agents assigned based on the presence of a defined set of mutations in putative cancer-driving pathways are required to address some of the current challenges and to identify patients likely to benefit from this approach.

Original languageEnglish (US)
JournalJournal of the National Cancer Institute
Volume107
Issue number4
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Kummar, S., Williams, P. M., Lih, C. J., Polley, E., Chen, A. P., Rubinstein, L. V., Zhao, Y., Simon, R. M., Conley, B. A., & Doroshow, J. H. (2015). Application of molecular profiling in clinical trials for advanced metastatic cancers. Journal of the National Cancer Institute, 107(4). https://doi.org/10.1093/jnci/djv003