Today’s medical cancer treatment is not limited to surgery, radiation and chemotherapy. Advances in personalized cancer medicine include a growing number of targeted treatments based on genetic analysis of a patient’s tumor.
Through analysis of next-generation DNA sequencing, a team of medical experts on a molecular tumor board can help oncologists choose targeted therapies tailored to each patients’ individual needs.
A new University of Kentucky Markey Cancer Center clinical trial — Precision Medicine Randomized Clinical Trial Comparing Molecular Tumor Board Assisted Care to Usual Care (PRiMAL) — will examine the impact molecular tumor board review has in cancer patient outcomes.
Jill Kolesar, Pharm.D., a professor in UK’s College of Pharmacy and co-director of the UK Markey Cancer Center Molecular Tumor Board, is principal investigator of the study, which is supported by a grant from Eli Lilly and Company.
The five-year randomized clinical trial will follow treatment and outcomes for 500 patients with advanced non-small cell lung cancer, the most common type of lung cancer. Patients will be recruited from community medical oncology practices throughout Kentucky, primarily from rural and medically underserved areas that carry the highest cancer burden.
“Advances in precision medicine offer more hope for patients than ever before, with personalized cancer therapies quickly becoming approved for multiple molecular targets,” said Kolesar, who also directs Markey’s Precision Medicine Center. “With Kentucky leading the nation in lung cancer incidence and mortality, PRiMAL will provide a significant understanding of the direct impact that access to this approach to personalized medicine can have in the Commonwealth and beyond.”
The study will compare MTB-directed therapy with usual care for patients with stage IIb-IV non-small cell lung cancer. Those receiving MTB-directed therapy will have their cases reviewed by Markey’s Molecular Tumor Board.
Launched in 2016, Markey’s Molecular Tumor Board includes representation from medical oncology, surgical oncology, pathology, radiology, genetic counseling, clinical pharmacology as well as basic scientists. The board meets twice a month to review patient genomic reports on a case-by-case basis and may recommend three types of potential care: therapies for that patient's cancer type that are approved by the Food and Drug Administration (FDA), FDA-approved therapies in another tumor type and potential clinical trials.
Review is provided at no cost to physicians at UK HealthCare and at regional affiliates throughout Kentucky — providing access to a service usually reserved to academic medical centers.
The study, which began recruitment in spring 2022, will measure overall survival and quality of life for patients receiving MTB-assisted care and usual care. The molecular characteristics of patients’ tumors will also help direct the development of new therapies and clinical trials that target the types of cancers found at Markey and throughout Kentucky.
PRiMAL is also supported by Breath of Hope Kentucky, a local nonprofit organization focused on awareness, prevention and early detection of lung cancer.