The agnostic therapy enables progress from a tumor-based approach to a approach based on biology and genomic changes. This is how his presentation started Jesus Garcia Foncillas, Director of the OncoHealth Institute, in the ‘Personalized Medicine and Agnostic Therapies’ debate at the VI Symposium of Liquid Biopsy.
The discovery of genetic changes it completely transforms research and its translation into practice. Treatment based solely on molecular alteration, regardless of the type and location of the tumor, is a reality in precision medicine. This opens up a whole host of challenges and treatment challenges that are not based on the target organ, but rather are therapies that strictly target a genetic profile.
In the field of agnostic therapies, the oncologist has it intratumoral gene fusions . “We have two drugs directed against NTRK (larotrectinib and entrectinib) with amazing results and a long response, ”said Foncillas.
To detect resistance mechanisms which, sometimes involving the presence of mutations in the domain of tyrosine kinase activity of this gene fusion, has led to a second generation NTKR inhibitors able to act on these resistance mutations: reprotectinib y selitrectinib.
“Reprotectinib is a drug that, in addition to acting against cases NTKR also acts against Ros1 and ALK. This means that we have a huge number of different tumors in which to identify these gene fusions, ”said the expert. Selitrectinib is able to act in those NTKR cases with mutation in the domain of tyrosine kinase activity.
Foncillas remembered that too ALK mergers they can be detected in different types of tumors. “It has been described in breast cancer, colorectal cancer, lung cancer … We have been able to detect it various resistance mutations with the first generation ALK, ”says the specialist.
In conclusion, Foncillas has brought attention to the new paradigm of oncology. “We have events such as gene fusions that can be detected in liquid biopsy. We want to provide better solutions for cancer patients and the detection of these genetic events could be the basis for improving their lives, ”he said.
In this sense, Razelle short skirta professor at MD Anderson Cancer University in Houston, Texas, who also participated in this table, emphasized the enthusiasm that the data provided by the NGS initially aroused. However, “late-stage metastatic tumors were very complex and had many problems because they were different,” the specialist continued. “Today we don’t have to look for commonalities in patients because we can analyze genomics and only get one combination of drugs that address genomic changes of that drug, ”he added.