Chemogenomic Approach Feasible for Tailoring Therapy for Relapsed/Refractory AML
Findings from a feasibility study show that combining targeted next-generation sequencing (tNGS) and drug sensitivity/resistance profiling (DSRP) is a promising approach for determining a tailored treatment strategy for patients with relapsed or refractory acute myeloid leukemia (AML; Blood Cancer J. 2020;10[6]:64).
“[tNGS and ex vivo DSRP] have laid foundations defining the functional genomic landscape of [AML] and premises of personalized medicine to guide treatment options for patients with aggressive and/or chemorefractory hematological malignancies,” wrote lead investigator Aude Collignon, MD, Haematology Department, Institut Paoli-Calmettes, Aix-Marseille Université, France, and colleagues.
Using a pool of 55 patients with relapsed or refractory AML, Dr Collignon et al evaluated the feasibility of a tailored treatment strategy guided by systematic parallel ex vivo DSRP and tNGS.
Ultimately, a personalized treatment approach issued by an institutional personalized committee was achievable for 47 (85%) of patients.
Of these 47 unique treatment approaches, 5 and 6 were based on tNGS only and DSRP only, respectively; 36 were based on tNGS and DSRP, which the investigators said yielded more options and a better rationale.
Of note, for 28 (58.3%) patients, tailored treatment strategies were developed in <21 days.
Across an average of 3 to 4 potentially active drugs selected for each patient, only 5 patients had samples resistant to the entire drug panel.
Among 17 patients who were given therapy guided by tailored treatment strategies, 4 had complete remissions, 1 had a partial remission, and 5 had reduced peripheral blast counts.
“Our results show that chemogenomic combining tNGS with DSRP to determine a [tailored treatment strategy] is a promising approach to propose patient-specific treatment options within 21 days,” Dr Collignon and colleagues stated.—Hina Porcelli
