The Impact of Foundation Medicine Testing on Cancer Patients: A Single Academic Centre Experience

Dalia Karol; Mathieu McKinnon; Lenah Mukhtar; Arif Awan; Bryan Lo; Paul Wheatley-Price

doi:10.3389/fonc.2021.687730

The Impact of Foundation Medicine Testing on Cancer Patients: A Single Academic Centre Experience

Front Oncol. 2021 Jul 26:11:687730. doi: 10.3389/fonc.2021.687730. eCollection 2021.

Authors

Dalia Karol¹, Mathieu McKinnon¹, Lenah Mukhtar², Arif Awan^{1

3

2}, Bryan Lo⁴, Paul Wheatley-Price^{1

3

2}

Affiliations

¹ Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
² The Ottawa Hospital Research Institute, Ottawa, ON, Canada.
³ Department of Medicine, Division of Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada.
⁴ Department of Anatomical Pathology, The Ottawa Hospital, Ottawa, ON, Canada.

Abstract

Background: The use of Next-Generation Sequencing (NGS) has recently allowed significant improvements in cancer treatment. Foundation Medicine^® (FM) provides a genomic profiling test based on NGS for a variety of cancers. However, it is unclear if the Foundation Medicine test would result in a better outcome than the standard on-site molecular testing. In this retrospective chart review, we identified the FM cases from an academic Canadian hospital and determined whether these test results improved treatment options for those patients.

Materials and methods: A retrospective analysis was performed on patients with solid tumors who had FM testing between May 1, 2014 and May 1, 2018. Clinical factors and outcomes were measured using descriptive statistics using Microsoft Excel^® Software.

Results: Out of 66 FM tests, eight patients (= 12%) had a direct change in therapy based on the FM tests. Identified were 285 oncogenic mutations (median 1, range 0-31); where TP53 (n = 31, 10.9%), CDKN2A (n = 19, 6.7%), KRAS (n = 16, 5.6%) and APC (n = 9, 3.2%) were the most common FM mutations identified.

Conclusion: A small proportion of FM reports identified actionable mutations and led to direct treatment change. FM testing is expensive and a few of the identified mutations are now part of routine on-site testing. NGS testing is likely to become more widespread, but this research suggests that its true clinical impact may be restricted to a minority of patients.

Keywords: Foundation Medicine; cancer; medical oncology; mutation; next-generation sequencing; precision medicine.