Table 1.
Tumor type and clinician and MP-guided therapy recommendation, MP results, and clinical outcomes: heavily pretreated group (HPT).
| Tumor location | Prior lines | Next best treatment: clinician-defined | Next best treatment: MP-defined | Clinical observationsa | Biomarkers with/without benefit | Chemotherapy versus biological/targeted therapy | PFS ratiob |
|---|---|---|---|---|---|---|---|
| Cervical | 2 | Irinotecan + 5-FU (FOLFIRI started) | CB | 5/5 | 7 versus 2 | 1.91 | |
| Gall bladder | 3 | FOLFIRI | CB | 3/5 | 5 versus 0 | 2.40 | |
| Skin (Merckel) | 3 | Epirubicin + cisplatin + 5-FU | P | 4/5 | 8 versus 0 | 1.50 | |
| Colorectal | 3 | Mitoxantrone/5-FU | Epirubicin + cisplatin + 5-FU | P | 4/5 | 8 versus 0 | 0.28 |
| Cervical | 2 | Nil | FOLFIRI | CB | 15/4 | 10 versus 7 | 1.43 |
| Pancreas (adenocarcinoma) | 2 | Nil | Epirubicin + cisplatin + 5-FU then trastuzumab (?)/erlotinib | CB | 7/2 | 7 versus 6 | 1.33 |
| Gastric | 2 | FOLFIRI | Gemcitabine + oxaliplatin | CB | 15/5 | 12 versus 3 | 1.76 |
| Leiomyosarcoma | 2 | Trabectedin | Sunitinib | CB | 11/6 | 9 versus 7 | 14.87 |
| Breast (ER−/HER2+) | 3 | Trastuzumab/capecitabine then liposomal doxorubicin then trastuzumab/irinotecan | Trastuzumab + irinotecan | CB | 15/9 | 20 versus 3 | 0.67 |
| Uterus | 2 | Doxorubicin + cyclophosphamide | P | 6/16 | 8 versus 0 | 0.28 | |
| Breast | 2 | Nab-paclitaxel (intolerant), cyclophosphamide + methotrexate + 5-FU | P | 8/11 | 17 versus 0 | NA | |
| Small bowel | 2 | Died before assessment | P | 6/16 | 7 versus 0 | NA | |
| Esophageal | 2 | FOLFIRI | P | 7/16 | 7 versus 2 | NA | |
| Lung | 2 | Cisplatin + pemetrexed | CB | 14/12 | 7 versus 3 | 0.59 | |
| Malignant mesothelioma | 2 | Cisplatin + pemetrexed | Cisplatin + nab-paclitaxel + doxorubicin | P | 5/19 | 4 versus 0 | NA |
| Ovarian | 3 | Nab-paclitaxel | Topotecan (also anthracyclines/nab-paclitaxel/hormones) | CB | 8/15 | 12 versus 0 | 1.00 |
| Cholangiocarcinoma | 2 | Epirubicin + cisplatin + 5-FU | Cisplatin + gemcitabine | CB | 5/13 | 7 versus 0 | NA |
| Mesothelioma | 2 | Nil | FOLFIRI | P | 2/16 | 5 versus 0 | 0.70 |
| Gastrointestinal | 2 | FOLFIRI | FOLFIRI | P | 4/18 | 5 versus 0 | 0.77 |
| Colon (adenocarcinoma) | 2 | Mitomycin-C + 5-FU | Carboplatin + gemcitabine | CB | 13/8 | 10 versus 2 | 1.50 |
| Cervical | 2 | Irinotecan + 5-FU (FOLFIRI started) | CB | 5/5 | 7 versus 2 | 2.00 | |
| Ovarian (serous adenocarcinoma) | 2 | Cisplatin + liposomal doxorubicin | Carboplatin + liposomal doxorubicin | CB | 9/9 | 14 versus 0 | 3.80 |
| Lung (adenocarcinoma) | 3 | Vinorelbine | Nab-paclitaxel | P | 10/11 | 9 versus 0 | NA |
| Pleura (adenocarcinoma) | 3 | FOLFIRI | CB | 9/6 | 11 versus 0 | 2.80 | |
| Prostate | 3 | Mitoxantrone | Irinotecan + 5-FU | CB | 12/5 | 16 versus 0 | 1.83 |
| Ovarian (serous adenocarcinoma) | 2 | Cisplatin + liposomal doxorubicin | Cisplatin + liposomal doxorubicin | CB | 9/4 | 10 versus 0 | 3.00 |
| Ovarian (serous adenocarcinoma) | 2 | Cisplatin + liposomal doxorubicin | Doxorubicin | P | 6/8 | 7 versus 2 | 0.50 |
| Colon (adenocarcinoma) | 2 | Gemcitabine + nab-paclitaxel | P | 8/9 | 8 versus 0 | 0.87 | |
| Mesothelioma | 2 | Vinorelbine | Gemcitabine + nab-paclitaxel | CB | 8/7 | 7 versus 0 | 0.30 |
| Gastric (adenocarcinoma) | 2 | Etoposide + leucovorin + 5-FU | FOLFIRI | CB | 10/6 | 11 versus 3 | 2.85 |
| Ductal breast carcinoma | 1 | Nab-paclitaxel | CB | 10/3 | 16 versus 3 | NA | |
|
| |||||||
| Totals | CB = 19; P = 12 | 253/279 | 291 versus 45 | ||||
aCB = clinical benefit (QOL/PS/general symptoms/weight and imaging results improved or stable); NA = not available; P = progression (QOL/PS/general symptoms/weight and imaging results declined or deteriorated).
bRatio of PFS with therapy suggested by MP versus that with prior line of therapy.
FOLFIRI, irinotecan + 5-FU + folinic acid; PFS, progression-free survival; PS, performance status; QOL, quality of life.