Quantifying the expanding landscape of clinical actionability for patients with cancer Journal Article


Authors: Suehnholz, S. P.; Nissan, M. H.; Zhang, H.; Kundra, R.; Nandakumar, S.; Lu, C.; Carrero, S.; Dhaneshwar, A.; Fernandez, N.; Xu, B. W.; Arcila, M. E.; Zehir, A.; Syed, A.; Brannon, A. R.; Rudolph, J. E.; Paraiso, E.; Sabbatini, P. J.; Levine, R. L.; Dogan, A.; Gao, J.; Ladanyi, M.; Drilon, A.; Berger, M. F.; Solit, D. B.; Schultz, N.; Chakravarty, D.
Article Title: Quantifying the expanding landscape of clinical actionability for patients with cancer
Abstract: There is a continuing debate about the proportion of cancer patients that benefit from precision oncology, attributable in part to conflicting views as to which molecular alterations are clinically actionable. To quantify the expansion of clinical actionability since 2017, we annotated 47,271 solid tumors sequenced with the MSK-IMPACT clinical assay using two temporally distinct versions of the OncoKB knowledge base deployed 5 years apart. Between 2017 and 2022, we observed an increase from 8.9% to 31.6% in the fraction of tumors harboring a standard care (level 1 or 2) predictive biomarker of therapy response and an almost halving of tumors carrying nonactionable drivers (44.2% to 22.8%). In tumors with limited or no clinical actionability, TP53 (43.2%), KRAS (19.2%), and CDKN2A (12.2%) were the most frequently altered genes. SIGNIFICANCE: Although clear progress has been made in expanding the availability of precision oncology-based treatment paradigms, our results suggest a continued unmet need for innovative therapeutic strategies, particularly for cancers with currently undruggable oncogenic drivers. See related commentary by Horak and Fröhling, p. 18. This article is featured in Selected Articles from This Issue, p. 5. ©2023 The Authors; Published by the American Association for Cancer Research.
Keywords: mutation; neoplasm; neoplasms; oncology; medical oncology; personalized medicine; procedures; humans; human; precision medicine
Journal Title: Cancer Discovery
Volume: 14
Issue: 1
ISSN: 2159-8274
Publisher: American Association for Cancer Research  
Date Published: 2024-01-01
Start Page: 49
End Page: 65
Language: English
DOI: 10.1158/2159-8290.Cd-23-0467
PUBMED: 37849038
PROVIDER: scopus
PMCID: PMC10784742
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Debyani Chakravarty -- Source: Scopus
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MSK Authors
  1. David Solit
    778 Solit
  2. Paul J Sabbatini
    262 Sabbatini
  3. Marc Ladanyi
    1326 Ladanyi
  4. Ross Levine
    775 Levine
  5. Ahmet Zehir
    343 Zehir
  6. Michael Forman Berger
    764 Berger
  7. Maria Eugenia Arcila
    657 Arcila
  8. Alexander Edward Drilon
    632 Drilon
  9. Jianjiong Gao
    132 Gao
  10. Nikolaus D Schultz
    486 Schultz
  11. Angela Rose Brannon
    99 Brannon
  12. Moriah Gabrielle Heller Nissan
    17 Nissan
  13. Aijazuddin Syed
    51 Syed
  14. Ahmet Dogan
    454 Dogan
  15. Ritika   Kundra
    88 Kundra
  16. Hongxin Zhang
    47 Zhang
  17. Julia E Rudolph
    16 Rudolph
  18. Calvin Lu
    5 Lu