Molecular analysis for refractory rare cancers: Sequencing battle continues - learnings for the MOSCATO-01 study

Crit Rev Oncol Hematol. 2023 Jan:181:103888. doi: 10.1016/j.critrevonc.2022.103888. Epub 2022 Nov 29.

Abstract

Background: For patients with metastatic rare cancers, treatments are limited. How systematic tumor sequencing can improve therapeutic possibilities in this population?

Patients and methods: Patients with rare cancer were identified in the MOSCATO-01 trial. Patients' outcome was measured by progression-free survival (PFS) and overall survival (OS).

Results: The most frequently identified histologic subypes were ovarian adenocarcinoma (N = 13), carcinoma of unknown primary (N = 11), and leiomyosarcoma (N = 10). Ninety-nine (39%) of them had at least one targetable cancer molecular alteration Forty-nine patients (50%) received the therapy proposed by the molecular tumor board, and 13 patients (26%, 95%CI 15-41%) achieved a PFS2/PFS1 > 1.3. The median PFS2 on matched treatment subgroup was 2.3 months (95% CI 1.8-3.6) and the median OS was 11.4 months (95% CI 9-15.5).

Conclusions: The molecular screening of patients with refractory, metastatic rare cancers might increase the therapeutic options. Facilitating access strategy to molecular-driven clinical trials or agnostic-approved treatment is crucial.

Keywords: Early phases; Molecular screening; Precision medicine; Rare cancer; Targeted therapy.

Publication types

  • Review

MeSH terms

  • Clinical Trials as Topic
  • Humans
  • Neoplasms* / drug therapy
  • Progression-Free Survival