Utilization of Genomic Tumor Profiling in Pediatric Liquid Tumors: A Clinical Series
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Published:2023-04-19
Issue:2
Volume:15
Page:256-265
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ISSN:2038-8330
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Container-title:Hematology Reports
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language:en
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Short-container-title:Hematology Reports
Author:
Sharma Ishna1ORCID, Son Min Ji1, Motamedi Shoaleh1, Hoeft Alice23, Teller Christa2, Hamby Tyler3, Ray Anish12ORCID
Affiliation:
1. Texas College of Osteopathic Medicine, The University of North Texas Health Science Center, Fort Worth, TX 76107, USA 2. Department of Hematology/Oncology, Cook Children’s Medical Center, Fort Worth, TX 76104, USA 3. Department of Research Operations, Cook Children’s Medical Center, Fort Worth, TX 76104, USA
Abstract
Hematologic tumors are mostly treated with chemotherapies that have poor toxicity profiles. While molecular tumor profiling can expand therapeutic options, our understanding of potential targetable drivers comes from studies of adult liquid tumors, which does not necessarily translate to efficacious treatment in pediatric liquid tumors. There is also no consensus on when profiling should be performed and its use in guiding therapies. We describe a single institution’s experience in integrating profiling for liquid tumors. Pediatric patients diagnosed with leukemia or lymphoma and who underwent tumor profiling were retrospectively reviewed. Ten (83.3%) patients had relapsed disease prior to tumor profiling. Eleven (91.7%) patients had targetable alterations identified on profiling, and three (25%) received targeted therapy based on these variants. Of the three patients that received targeted therapy, two (66.7%) were living, and one (33.3%) decreased. For a portion of our relapsing and/or treatment-refractory patients, genetic profiling was feasible and useful in tailoring therapy to obtain stable or remission states. Practitioners may hesitate to deviate from the ‘standard of therapy’, resulting in the underutilization of profiling results. Prospective studies should identify actionable genetic variants found more frequently in pediatric liquid tumors and explore the benefits of proactive tumor profiling prior to the first relapse.
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