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@ARTICLE{Langenberg:181934,
author = {K. P. S. Langenberg and M. T. Meister and J. J. Bakhuizen
and J. M. Boer and N. K. A. van Eijkelenburg and E. Hulleman
and U. Ilan and E. J. Looze and M. P. Dierselhuis and J. van
der Lugt and W. Breunis and L. G. Schild and K. Ober and S.
R. van Hooff and M. A. Scheijde-Vermeulen and L. S.
Hiemcke-Jiwa and U. E. Flucke and M. E. G. Kranendonk and P.
Wesseling and E. Sonneveld and S. Punt and A. Boltjes and F.
van Dijk and E. T. P. Verwiel and R. Volckmann and J. Y.
Hehir-Kwa and L. A. Kester and M. M. J. Koudijs and E.
Waanders and F. C. P. Holstege and H. J. Vormoor and E. W.
Hoving and M. M. van Noesel and R. Pieters and M. Kool$^*$
and M. Stumpf and M. Blattner-Johnson$^*$ and G. P.
Balasubramanian$^*$ and C. M. Van Tilburg$^*$ and B. C.
Jones$^*$ and D. T. W. Jones$^*$ and O. Witt$^*$ and S. M.
Pfister$^*$ and M. C. J. Jongmans and R. P. Kuiper and R. R.
de Krijger and M. H. W. Wijnen and M. L. den Boer and C. M.
Zwaan and P. Kemmeren and J. Koster and B. B. J. Tops and B.
F. Goemans and J. J. Molenaar},
title = {{I}mplementation of paediatric precision oncology into
clinical practice: {T}he {I}ndividualized {T}herapies for
{C}hildren with cancer program 'i{THER}'.},
journal = {European journal of cancer},
volume = {175},
issn = {0014-2964},
address = {Amsterdam [u.a.]},
publisher = {Elsevier},
reportid = {DKFZ-2022-02304},
pages = {311 - 325},
year = {2022},
abstract = {iTHER is a Dutch prospective national precision oncology
program aiming to define tumour molecular profiles in
children and adolescents with primary very high-risk,
relapsed, or refractory paediatric tumours. Between April
2017 and April 2021, 302 samples from 253 patients were
included. Comprehensive molecular profiling including
low-coverage whole genome sequencing (lcWGS), whole exome
sequencing (WES), RNA sequencing (RNA-seq), Affymetrix,
and/or 850k methylation profiling was successfully performed
for 226 samples with at least $20\%$ tumour content.
Germline pathogenic variants were identified in $16\%$ of
patients (35/219), of which 22 variants were judged
causative for a cancer predisposition syndrome. At least one
somatic alteration was detected in 204 $(90.3\%),$ and 185
$(81.9\%)$ were considered druggable, with clinical priority
very high $(6.1\%),$ high $(21.3\%),$ moderate $(26.0\%),$
intermediate $(36.1\%),$ and borderline $(10.5\%)$ priority.
iTHER led to revision or refinement of diagnosis in 8
patients $(3.5\%).$ Temporal heterogeneity was observed in
paired samples of 15 patients, indicating the value of
sequential analyses. Of 137 patients with follow-up beyond
twelve months, 21 molecularly matched treatments were
applied in 19 patients $(13.9\%),$ with clinical benefit in
few. Most relevant barriers to not applying targeted
therapies included poor performance status, as well as
limited access to drugs within clinical trial. iTHER
demonstrates the feasibility of comprehensive molecular
profiling across all ages, tumour types and stages in
paediatric cancers, informing of diagnostic, prognostic, and
targetable alterations as well as reportable germline
variants. Therefore, WES and RNA-seq is nowadays standard
clinical care at the Princess Máxima Center for all
children with cancer, including patients at primary
diagnosis. Improved access to innovative treatments within
biology-driven combination trials is required to ultimately
improve survival.},
keywords = {Adolescent (Other) / Cancer (Other) / Child (Other) /
Hereditary (Other) / Molecular biology (Other) / Molecular
targeted therapy (Other) / Next-generation sequencing
(Other) / Precision medicine (Other)},
cin = {B062 / HD01 / B360 / B310},
ddc = {610},
cid = {I:(DE-He78)B062-20160331 / I:(DE-He78)HD01-20160331 /
I:(DE-He78)B360-20160331 / I:(DE-He78)B310-20160331},
pnm = {312 - Funktionelle und strukturelle Genomforschung
(POF4-312)},
pid = {G:(DE-HGF)POF4-312},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:36182817},
doi = {10.1016/j.ejca.2022.09.001},
url = {https://inrepo02.dkfz.de/record/181934},
}