Matched Targeted Therapy for Pediatric Patients with Relapsed, Refractory, or High-Risk Leukemias: A Report from the LEAP Consortium

Matched Targeted Therapy for Pediatric Patients with Relapsed, Refractory, or High-Risk Leukemias: A Report from the LEAP Consortium

Despite a remarkable increase in the genomic profiling of cancer, integration of genomic discoveries into clinical care has lagged behind. We report the feasibility of rapid identification of targetable mutations in 153 pediatric patients with relapsed/refractory or high-risk leukemias enrolled on a...

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Main Authors: Yana Pikman, Sarah K. Tasian, Maria Luisa Sulis, Kristen E. Stevenson, Traci M. Blonquist, Beth Apsel Winger, Todd M. Cooper, Melinda Pauly, Kelly W. Maloney, Michael J. Burke, Patrick A. Brown, Nathan Gossai, Jennifer L. McNeer, Neerav Shukla, Peter D. Cole, Justine M. Kahn, Jing Chen, Matthew J. Barth, Jeffrey A. Magee, Lisa Gennarini, Asmani A. Adhav, Catherine Clinton, Nicole Ocasio-Martinez, Giacomo Gotti, Yuting Li, Shan Lin, Alma Imamović, Cristina E. Tognon, Tasleema Patel, Haley L. Faust, Cristina F. Contreras, Anjali Cremer, Wilian A. Cortopassi, Diego Garrido Ruiz, Matthew P. Jacobson, Neekesh V. Dharia, Angela Su, Amanda L. Robichaud, Amy Saur Conway, Katherine Tarlock, Elliot Stieglitz, Andrew E. Place, Alexandre Puissant, Stephen P. Hunger, Annette S. Kim, Neal I. Lindeman, Lia Gore, Katherine A. Janeway, Lewis B. Silverman, Jeffrey W. Tyner, Marian H. Harris, Mignon L. Loh, Kimberly Stegmaier
格式: Artigo
语言:英语
出版: 2021
在线阅读:https://doi.org/10.1158/2159-8290.cd-20-0564
https://aacrjournals.org/cancerdiscovery/article-pdf/11/6/1424/3105230/1424.pdf
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总结:Despite a remarkable increase in the genomic profiling of cancer, integration of genomic discoveries into clinical care has lagged behind. We report the feasibility of rapid identification of targetable mutations in 153 pediatric patients with relapsed/refractory or high-risk leukemias enrolled on a prospective clinical trial conducted by the LEAP Consortium. Eighteen percent of patients had a high confidence Tier 1 or 2 recommendation. We describe clinical responses in the 14% of patients with relapsed/refractory leukemia who received the matched targeted therapy. Further, in order to inform future targeted therapy for patients, we validated variants of uncertain significance, performed ex vivo drug-sensitivity testing in patient leukemia samples, and identified new combinations of targeted therapies in cell lines and patient-derived xenograft models. These data and our collaborative approach should inform the design of future precision medicine trials. SIGNIFICANCE: Patients with relapsed/refractory leukemias face limited treatment options. Systematic integration of precision medicine efforts can inform therapy. We report the feasibility of identifying targetable mutations in children with leukemia and describe correlative biology studies validating therapeutic hypotheses and novel mutations.See related commentary by Bornhauser and Bourquin, p. 1322.This article is highlighted in the In This Issue feature, p. 1307.

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