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Precision medicine becomes reality—tumor type‐agnostic therapy

Overview of attention for article published in Cancer Communications, March 2018
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Title
Precision medicine becomes reality—tumor type‐agnostic therapy
Published in
Cancer Communications, March 2018
DOI 10.1186/s40880-018-0274-3
Pubmed ID
Authors

Li Yan, Wei Zhang

Abstract

Precision medicine just witnessed two breakthroughs in oncology in 2017. Pembrolizumab (Keytruda), Merck's anti-programmed cell death-1 (PD-1) monoclonal antibody (mAb), received accelerated approval in May 2017 by the US Food and Drug Administration for the treatment of adult and pediatric patients with unresectable or metastatic solid tumors that have been identified as having microsatellite instability-high (MSI-H) or deficient DNA mismatch repair (dMMR). Shortly after, nivolumab (Opdivo), Bristol-Myers Squibb's anti-PD-1 mAb, gained an accelerated approval in August 2017 for adult and pediatric patients with MSI-H or dMMR metastatic colorectal cancer that has progressed after standard chemotherapy. These regulatory approvals marked an important milestone that a cancer treatment may be approved based on a common biomarker rather than the anatomic location in the body where the tumor originated, and therefore established a precedent for tumor type-agnostic therapy. In the 2017 American Society for Clinical Oncology annual meeting, larotrectinib (LOXO-101), Loxooncology's oral, potent, and selective inhibitor of tropomyosin receptor kinases (TRK), demonstrated unprecedented efficacy on unresectable or metastatic solid tumors with neurotrophic tropomyosin receptor kinase (NTRK)-fusion proteins in adult and pediatric patients. Both the anti-PD-1 mAbs and the TRK-targeting therapies share some basic features: (a) biomarker-based, well-defined rare patient population; (b) exceptionally high clinical efficacy, e.g., near 40% overall response rate (ORR) for pembrolizumab across 15 tumor types with MSI-H/dMMR and 75% ORR for larotrectinib across more than 12 tumor types with NTRK-fusion proteins; (c) durable responses lasting at least 6 months with complete responses observed; and (d) parallel development in adult and pediatric populations. With increasing accessibility to genetic analysis tools such as next-generation sequencing, tumor type-agnostic therapy has become a reality, both during clinical development and in clinical practice. Adjustments in our approaches to developing new anti-cancer drugs and to adopting these new cancer treatments in clinical practice need to occur in order to prepare ourselves for the new era of precision medicine.

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Geographical breakdown

Country Count As %
Unknown 152 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 23 15%
Student > Master 21 14%
Researcher 15 10%
Other 14 9%
Student > Bachelor 10 7%
Other 23 15%
Unknown 46 30%
Readers by discipline Count As %
Medicine and Dentistry 43 28%
Biochemistry, Genetics and Molecular Biology 24 16%
Pharmacology, Toxicology and Pharmaceutical Science 18 12%
Agricultural and Biological Sciences 5 3%
Nursing and Health Professions 5 3%
Other 10 7%
Unknown 47 31%