Clinical relevance of FoundationOne in lung cancerOver the last decade alone, the number of targetable lung cancer genes has increased.16 In 2015, 96 genomic alterations were identified across 31 patients with lung adenocarcinoma.8 As the fraction of known cancer genes grows, the number of targets for specific therapies increases and it becomes less feasible to test for each individual alteration.5,8,10,11 FoundationOne overcomes this issue by achieving broad coverage of hundreds of known oncogenes in order to maximise the chance of identifying clinically relevant alterations in each patient’s tumour sample.1,5
FoundationOne could expand treatment options for lung cancer patients
FoundationOne can detect alterations in lung cancers that may be missed by other standard of care measures, including non-NGS fluorescence in situ hybridisation (FISH) testing, potentially expanding treatment options.18 FoundationOne is suitable in the profiling of all solid tumours, including non-small cell lung cancer (NSCLC) and lung adenocarcinomas.8,18
In 2015, 96 genomic alterations were detected across 31 patients with lung adenocarcinoma using FoundationOne’s comprehensive genomic profiling.8
In a study of people with NSCLC, comprehensive genomic profiling identified 35% of ALK gene alterations that were missed by FISH.18
characterised NSCLC driver oncogenes*19. Among these:
alterations as listed
in the NCCN guidelines**19
*EGFR, ALK, ROS1, RET, met, braf, erbb2, kras
**Alteration definied as actionable if associated with potential benfit from
targeted therapy or enabled enrolment in mechanism-driven clinical trial.
having at least 1 driver associated with US FDA approved
anticancer therapies for all cancer types (n=73/82).2
with a change in treatment strategy
(i.e. intiation of appropriate targeted
change in therapy, with 14%
(5/43) achieveing a complete
response and 50% experiencing
a partial response (17/43)1
In order to identify the most appropriate targeted treatment, there is a need for an accurate diagnostic test that can identify all clinically relevant alterations.5,8
The National Comprehensive Cancer Network guidelines for NSCLC strongly recommend the use of broader molecular profiling for lung cancer, providing an even greater rationale for the use of FoundationOne tumour profiling.20
In addition to the identification of these alterations, FoundationOne has also been used to identify a possible association between TMB and predicted response to immunotherapy, meaning that physicians could potentially use FoundationOne in order to estimate patient response to immunotherapy.2
Is FoundationOne suitable for all cancer types?
FoundationOne is suitable for all solid cancer types, including rare cancers and cancers of unknown origin, and in recurrent or metastatic solid tumour cancers, including all lung cancer types.1,7
FoundationOne can be useful in cases where there are many possible treatment options to choose between, limited treatment options or where the solid tumour may have uncommon or rare alterations that would be missed by routine testing.8–10
- FoundationOne technical information.
- Rozenblum AB et al. J Thorac Oncol 2017; 2:258–268 (and supplementary material).
- Chalmers ZR et al. Genome Med 2017; 9:34.
- Genomeweb. Foundation Medicine Q3 revenues up 45 percent. Available at: https://www.genomeweb.com/molecular-diagnostics/foundation-medicine-q3-revenues-45-percent [accessed November 2017].
- Frampton, GM et al. Nat Biotechnol 2013; 31:1023–1031
- Foundation Medicine. FoundationCORE press release, June 2016.
- Schwaederle M et al. Mol Cancer Ther 2015; 14:1488–1494.
- Drilon A et al. Clin Cancer Res 2015; 16:3631–3639.
- Ross JS et al. Cancer 2016; 17:2654–2562.
- Hirsch FR et al. Lancet 2016; 388:1012–1024.
- Aitken M et al. Global Oncology Trend Report 2015. Available at: http://keionline.org/sites/default/files/IIHI_Oncology_Trend_Report_2015.pdf (accessed November 2017).
- Kos Z and Dabbs DJ. Histopathology 2016; 68:70–85.
- Bishop R. Bioscience Horizons 2010; 1:85–95.
- Chen AY-Y and Chen A. J Invest Dermatol 2013; 133:e8.
- Angulo B et al. PLoS One 2012; 8:e43842.
- Pao W and Girard N. Lancet Oncol 2011; 12:175–180.
- Jordan EJ et al. Cancer Discov 2017; 6:596–609.
- Ali SM et al. Oncologist 2016; 6:762–670.
- Suh JH et al. The Oncologist 2016; 21:684–691.
- National Comprehensive Cancer Network (NCCN) NSCLC guidelines, Version 9, 2017.
- Dillon JL et al. The Breast 2016; 29:202–207.
- Stephens PJ et al. Nature 2012; 7403:400–404.
- Eralp Y. Tranl Oncogenomics 2016; 8:1–7.
- Schrock AB et al. Clin Cancer Res 2016; 22:3281–3285.
- Chmielecki J et al. Oncologist 2015; 20:7–12.
- Yuan Y et al. Oncotarget 2012: doi: 10.18632/oncotarget.14476.
- Roche Foundation Medicine data on file.
- Masucci GV et al. Int J Immunother Cancer Res 2016; 4:16.
- National Cancer Institute (NIH). NCI dictionary of cancer terms. Available at: https://www.cancer.gov/publications/dictionaries/cancer-terms?cdrid=285933 [accessed November 2017].
- Sinicrope FA. Nat Rev Clin Oncol 2010; 7:174–177.
- The Cancer Genome Atlas Network, Nature 2012; 487:330–337.