Childhood Cancer Data Initiative Annual Symposium (Abstract Registration): Submission #47

Abstract Submission for Poster Presentation
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Abstract Title:: Real-World Experience of Pediatric Precision Oncology Cohort At a Single Institution: An Interim Analysis
Abstract::
Our primary aim is to study the real-world impact of integrative clinical sequencing (ICS) based pediatric precision oncology program on the outcomes of pediatric-AYA cancer patients at a single institution. 
Methods: Pediatric-AYA oncology patients (age 0-25yr) were enrolled and sequenced using methodology described previously.1 Longitudinal clinical data extracted from EHR using NCI supported tool EMERSE were entered into a REDCap. 
Results: Clinical characteristics are shown in Fig-1. Of 1000 patients enrolled, 925 (92.5%) were sequenced successfully, 235 (23.5%) underwent repeat ICS (Range 1-4). Interim analysis of the first 250 patients revealed 230 patients with full sequencing results. Of those, 133 (57.8%) patients had total 228 actionable alterations (AA) (mean1.71 AA /pt), of which 30 (13%) patients had germline AA.  Of the total AA, 64 patients had 84 SNV (Single Nucleotide Variants), 33 patients had 38 actionable fusions, and 46 had 76 actionable CNA’s (Copy Number Alterations). Fifty-one (22.2%) patients received a total of 96 targeted therapies (TT) supported by variant level evidence (VLE)2, 3 (L1=39, L2=5, L3=4, L4=4, Other=44), while 16 (7.0%) patients received 26 TT without AA based on clinician preference. Eighty-two (35.6%) patients with AA did not receive any TT. Sixty-five (28.3%) patients underwent repeat ICS, among which 9.2% (6) had additional AA identified and 4.6% (3) received TT based on repeat ICS.  
Conclusion: Interim analyses showed that 67 patients (29.1%) received TT with variable level of evidence. Outcomes of patients receiving TT including, EFS, OS and barrier in receiving TT despite having AA, are under further analyses. 


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Authors::
1. First Name: Lucas
   Last Name: Ebert
   Degree(s): B.S.
   Organization: Michigan Medicine
2. First Name: Malay 
   Last Name: Mody
   Degree(s): MPH
   Organization: Michigan Medicine
3. First Name: Joshua
   Last Name: Goldman
   Degree(s): M.D.
   Organization: Michigan Medicine
4. First Name: David
   Last Name: Hanauer
   Degree(s): M.D., M.S. 
   Organization: Michigan Medicine
5. First Name: Jamie
   Last Name: Estill
   Degree(s): M.S.
   Organization: Michigan Medicine
6. First Name: Brian
   Last Name: Magnuson
   Degree(s): Ph.D.
   Organization: Michigan Medicine
7. First Name: Carl
   Last Name: Koschmann
   Degree(s): M.D.
   Organization: Michigan Medicine
8. First Name: Arul
   Last Name: Chinnaiyan 
   Degree(s): M.D., Ph.D.
   Organization: Michigan Medicine
9. First Name: Rajen
   Last Name: Mody
   Degree(s): M.D., M.S. 
   Organization: Michigan Medicine
10. First Name: Chandan 
    Last Name: Kumar
    Degree(s): Ph.D.
    Organization: Michigan Medicine

Presenting Author:: Lucas Ebert/ Malay Mody
Institution:: Michigan Medicine
Email Address:: rmody@med.umich.edu