Long-term overall survival and prognostic score predicting survival: the IMPACT study in precision medicine

In conclusion, our data demonstrate that matched targeted therapy is associated with superior rates of objective response, PFS, and long-term OS compared to nonmatched therapy. The 3-year OS rate was 15% in the matched targeted group compared to 7% in the nonmatched group, and the 10-year OS rates were 6% and 1%, respectively.

Independent factors predicting shorter OS in multivariate analysis were used to develop a prognostic score to predict an individual patient’s risk of death. These factors were non-matched therapy, liver metastases, LDH > the upper limit of normal, and PI3k/ AKT/mTOR pathway alterations (score of 1 each), and performance status > 1 (score of 2). This prognostic model that includes molecular pathway abnormalities can be used to predict the expected OS of individual patients who are being considered for clinical trials.

Advances in technology and bioinformatics to identify driver molecular alterations; evolution of the global assessment of immune mechanisms and proteomic, transcriptomic, and epigenetic changes in individual patient tumor pathogenesis; and innovative, carefully designed clinical trials are expected to improve the implementation of precision medicine.

The full article can be downloaded below.