Precision medicine and its implementation in patients with NTRK fusion genes: perspective from developing countries
Por:
Cardona, AF, Arrieta, O, Ruiz-Patino, A, Sotelo, C, Zamudio-Molano, N, Zatarain-Barron, ZL, Ricaurte, L, Raez, L, Alvarez, MPP, Barron, F, Rojas, L, Rolfo, C, Karachaliou, N, Molina-Vila, MA and Rosell, R
Publicada:
1 jul 2020
Resumen:
Precision oncology is the field that places emphasis on the diagnosis and treatment of tumors that harbor specific genomic alterations susceptible to inhibition or modulation. Although most alterations are only present in a minority of patients, a substantial effect on survival can be observed in this subgroup. Mass genome sequencing has led to the identification of a specific driver in the translocations of the tropomyosin receptor kinase family (NTRK) in a subset of rare tumors both in children and in adults, and to the development and investigation of Larotrectinib. This medication was granted approval by the US Food and Drug Administration for NTRK-positive tumors, regardless of histology or age group, as such, larotrectinib was the first in its kind to be approved under the premise that molecular pattern is more important than histology in terms of therapeutic approach. It yielded significant results in disease control with good tolerability across a wide range of diseases including rare pediatric tumors, salivary gland tumors, gliomas, soft-tissue sarcomas, and thyroid carcinomas. In addition, and by taking different approaches in clinical trial design and conducting allocation based on biomarkers, the effects of target therapies can be isolated and quantified. Moreover, and considering developing nations and resource-limited settings, precision oncology could offer a tool to reduce cancer-related disability and hospital costs. In addition, developing nations also present patients with rare tumors that lack a chance of treatment, outside of clinical trials. This, in turn, offers the possibility for international collaboration, and contributes to employment, education, and health service provisions. The reviews of this paper are available via the supplemental material section.
Filiaciones:
Cardona, AF:
Clin Country, Clin & Translat Oncol Grp, Calle 116 9-72,C 318, Bogota, Colombia
Univ el Bosque, Mol Oncol & Biol Syst Res Grp FOX G, Bogota, Colombia
Fdn Clin & Appl Canc Res FICMAC, Bogota, Colombia
Arrieta, O:
Univ el Bosque, Mol Oncol & Biol Syst Res Grp FOX G, Bogota, Colombia
Inst Nacl Cancerol INCan, Thorac Oncol Unit, Mexico City, DF, Mexico
Ruiz-Patino, A:
Fdn Clin & Appl Canc Res FICMAC, Bogota, Colombia
Sotelo, C:
Univ el Bosque, Mol Oncol & Biol Syst Res Grp FOX G, Bogota, Colombia
Fdn Clin & Appl Canc Res FICMAC, Bogota, Colombia
Zamudio-Molano, N:
Fdn Clin & Appl Canc Res FICMAC, Bogota, Colombia
Zatarain-Barron, ZL:
Inst Nacl Cancerol INCan, Thorac Oncol Unit, Mexico City, DF, Mexico
Ricaurte, L:
Univ el Bosque, Mol Oncol & Biol Syst Res Grp FOX G, Bogota, Colombia
Fdn Clin & Appl Canc Res FICMAC, Bogota, Colombia
Mayo Clin, Pathol Dept, Rochester, MN USA
Raez, L:
Florida Int Univ FIU, Thorac Oncol Program, Mem Canc Inst MCI, Miami, FL USA
Alvarez, MPP:
Inst Nacl Cancerol INCan, Thorac Oncol Unit, Mexico City, DF, Mexico
Barron, F:
Inst Nacl Cancerol INCan, Thorac Oncol Unit, Mexico City, DF, Mexico
Rojas, L:
Fdn Clin & Appl Canc Res FICMAC, Bogota, Colombia
Clin Colsanitas, Oncol Dept, Bogota, Colombia
Rolfo, C:
Univ Maryland, Thorac Med Oncol & Early Clin Trials Unit, Baltimore, MD 21201 USA
Karachaliou, N:
Merck KGaA, Global Clin Dev, Darmstadt, Germany
Molina-Vila, MA:
Quiron Dexeus Univ Inst, Pangaea Oncol, Lab Mol Biol, Barcelona, Catalunya, Spain
:
Germans Trias & Pujol Res Inst & Hosp IGTP, Badalona, Catalunya, Spain
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