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‘Genome analysis-based therapy to help realize precision medicine’
  • By Lee Han-soo
  • Published 2019.10.15 17:50
  • Updated 2019.10.15 17:50
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Samsung Medical Center has become the world’s first hospital to demonstrate the effects of genome-based precision medicine on patients with metastatic gastric cancer, the hospital said Tuesday.

From left, Professors Lee Ji-yeon, Kim Seung-tae, Lee Hyuk, Kim Kyung-mi, and Kang Won-ki

A total of 772 patients with metastatic gastric cancer who completed primary chemotherapy from March 2014 to July 2018 participated in the research, titled VIKTORY (targeted agent eValuation In gastric cancer basket KORea).

The team analyzed the patient in a multi-omic fashion. They considered not only the genomic information of the patient but also several factors that could affect the disease, such as protein bodies.

Subsequently, the researchers selected the “umbrella trial” method to select the specific drugs needed to treat patients based on the analysis.

The umbrella trial is a study that has many different candidate drugs within one trial simultaneously. Researchers assign people to a particular treatment arm of the test based on their type of cancer and the specific molecular makeup of their cancer. MD Anderson, a leading U.S. medical institution on cancer, first introduced the method in 2008.

The team selected 715 patients who completed genome analysis and matched eight predetermined biomarkers.

Afterward, 105 patients selected according to the presence or absence of mutations in cancer-related genes biomarkers such as RAS, TP53, and PIK3C received drugs suitable for the corresponding biomarkers.

Among the remaining patients, 317 patients who needed or were able to undergo secondary treatment were monitored after taking the drug according to conventional treatment.

As a result, the survival rate between the two groups was statistically significant when reflecting age, sex, and the number of metastasized organs.

According to the team, the median survival for the group of patients who completed the second round of therapy was 6.9 months, while the group treated with biomarkers was 9.8 months.

The progression-free survival (PFS) period was also longer in the biomarker treatment group. The PFS was 5.7 months in the biomarker group and 3.8 months in the conventional group.

“The study provided an opportunity to explore the treatment potential of gastric cancers that did not respond to immunotherapy,” the team said. “This is because some of the biomarker group showed increased expression rate of PD-L1 protein, which is the standard for treatment after immunotherapy.”

“The study is significant as it was first research in the world to demonstrate precision medicine effect based on the value obtained by analyzing several cancer biomarkers at once with the genome, immunostaining, and RNA sequencing,” said Professor Lee Ji-yeon, the lead researcher for the project.

Professor Kim Kyung-mi, who was in charge of genome analysis, also said, “Gastric cancer is a very complex cancer that requires a variety of analytical techniques to improve patient prognosis. In the future, we will focus on more accurate patient-specific cancer analysis studies.”

The study, jointly conducted by Professors Lee Ji-yeon, Kim Kyung-mi, Kim Seung-tae, Lee Hyuk, and Kang Won-ki, was published both in the latest issue of Cancer Discovery and Nature News.


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