Study demonstrates benefits of molecular tumour analysis

Physicians base their decisions on established guidelines when selecting the appropriate therapy. Thanks to these guidelines, significantly better treatment results have been achieved in recent years, especially in the case of melanoma. However, even within these standard therapies, there are often several treatment options, and it is not always clear which therapy is the most likely to be successful for a particular patient. It becomes particularly challenging when standard therapies have been exhausted and there is a lack of scientifically supported evidence for further treatment.

Know each tumour down to the individual cell

Until now, cancer therapies have been determined primarily on the basis of the tissue where the tumour originated and its genetic characteristics. In the Tumor Profiler project, which has been ongoing since 2018, researchers are investigating how new molecular biological methods can help improve and expand treatment options for patients beyond standard therapies. Scientists and physicians from ETH Zurich, the University Hospital Zurich, the University of Zurich, the University Hospital Basel and the pharmaceutical company Roche are working together on this project. They take advantage of the fact that every tumour is unique right down to the individual cells and they use nine technologies to analyse a tumour at the individual cell level.

The information obtained in this way creates a comprehensive picture of the biological processes in the tumour, from DNA to RNA and proteins. This knowledge then makes it possible to determine the most effective treatment for the individual patient from the available forms of therapy, especially medications. This data-driven approach also makes it possible to include drugs used to treat other cancers in the evaluation, thus broadening the range of treatment options on a case-by-case basis.

In a first phase of the Tumor Profiler project, it was investigated which molecular biological technologies provide relevant information for treatment and showed that such comprehensive analyses are feasible and that the necessary processing of the enormous amounts of data is possible. The next step was to examine how tumour profiling can be implemented in practice.

Nine molecular methods and practical application

In a prospective, multicentre observational study, over 100 scientists investigated whether this approach is feasible in the hospital and whether it offers advantages. The focus was on how long it takes for the tumour analysis to be available and how the treating physicians assess the resulting recommendations ¨C two key factors for the successful application of tumour profiling in practice. To this end, they analysed the tumours of 116 patients.

Each sample provided around 43,000 data points, which corresponds to about half a terabyte. The physicians used this information to derive individual treatment recommendations. This was the first study worldwide to use nine molecular biological technologies for profiling in parallel and to use the data collected to make treatment predictions for the benefit of the treating physicians in the clinic.

Rapid analysis and individual recommendations

The study was able to show that the recommendations provided by the tumour profiling were available after four weeks and that in 75 per cent of cases, the treating specialists found them helpful for the choice of therapy and provided them with substantial information. ¡°These values and information show us that the recommendations from tumour profiling are available within a reasonable period of time and with tangible and directly implementable benefits for the treating physicians,¡± says Nicola Miglino, research assistant at the Department of Medical Oncology and Hematology at the University Hospital Zurich and one of the lead authors of the study.

The tumour board at the University Hospital Zurich, an association of oncology specialists, assessed the tumour profiler data and proposed specific therapies tailored to the study participants based on this information. It was found that patients whose treatment was based on information from the Profiler data responded more often to the therapy than patients who did not participate in the program.

¡°This is an encouraging result that goes beyond our actual goal of the study, but one that still needs to be confirmed in prospective and randomized clinical trials involving more patients,¡± is how Andreas Wicki, Professor of Oncology at the University of Zurich and co-director of the Tumor Profiler Center, summarizes the results. He continues: ¡°This study is a major step toward data-based medicine. It paves the way for new clinical trials that don¡¯t test individual drugs, but actually predict the most effective therapy.¡±

This article is based on a external page press release from the University Hospital Zurich.