Abstract C049: Copenhagen Prospective Personalized Oncology (CoPPO) – The utility of using genomic profiling for tailored therapy in a Phase 1 setting
Authors: Belcaid Laila , Hoejgaard Martin , Tuxen Ida , Spanggaard Iben , Lassen Ulrik , Nielsen Finn Cilius , Yde Christina Westmose , Rohrberg Kristoffer 
Published: December 2023

Purpose: In recent years, targeted therapy based on the molecular characterization of tumors has been among the most remarkable advances in cancer medicine. Here, we report the impact of comprehensive genomic profiling in patients (pts) with advanced solid tumors at the Phase 1 unit, Department of Oncology, Rigshospitalet, Denmark.

Materials and Methods: A prospective, single-center, single-arm open label study (NCT02290522) was conducted, enrolling pts with advanced cancer referred to a Phase I Unit. Fresh tumor tissue 18G core needle or equivalent preserved in RNAlater was obtained for whole genome or exome sequencing and RNA sequencing. In cases where fresh tumor tissue was unavailable, archived formalin-fixed paraffin-embedded tumor tissue or circulating tumor DNA extracted from plasma were obtained. Each individual genomic report was reviewed and discussed by a multidisciplinary tumor board dedicated to precision medicine. When possible, pts were treated with regimen matched to the genomic profile.

Results: Between April 2013 and December 2022, a total of 2151 pts with advanced cancer and exhausted treatment options were enrolled. Median age of pts was 62 years (range: 17- 87) and most common tumor types included colorectal cancer (N=465, 22%), breast cancer (N=290, 13%), non-small cell lung cancer (N = 251, 12%) and prostate cancer (N = 174, 8%). Genomic profiles were obtained in 1870 pts (87%). At least one actionable target was identified in 1067 pts (57%). The most common actionable targets were expression profiles matched to monoclonal antibodies (N=559, 52%), alteration of the DNA damage repair response pathway (N=407, 38%) and tumor mutational burden-high (N=84, 8%). Overall, 261 pts (24%) with an actionable target were treated with targeted therapy. 11 pts were treated with more than one line of targeted therapy. In total 276 targeted treatment regimens were initiated. The treatments predominantly targeted; the DNA damage repair response pathway (N=54, 20%), BRAF V600E mutation (N= 47, 17%), expression profiles matched to monoclonal antibodies (N=35, 13%), ERBB2 family pathway alterations (N=34, 12%) and tumor mutational burden-high (N=34, 12%).

Conclusion: This large-scale study demonstrates that genomic profiling is efficient to identify actionable targets and to match pts to targeted therapies. Outcomes of pts treated with matched therapy will be presented at the meeting.

Citation Format: Laila Belcaid, Martin Hoejgaard, Ida Tuxen, Iben Spanggaard, Ulrik Lassen, Finn Cilius Nielsen, Christina Westmose Yde, Kristoffer Rohrberg. Copenhagen Prospective Personalized Oncology (CoPPO) – The utility of using genomic profiling for tailored therapy in a Phase 1 setting [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2023 Oct 11-15; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2023;22(12 Suppl):Abstract nr C049.