Analysis of expension of clinical actionability for cancer patients, 2017-2022

There is a continuing debate about the proportion of cancer patients who benefit from precision oncology, attributable in part to conflicting views as to which molecular alterations are clinically actionable. To quantify the expansion of clinical actionability since 2017, researchers at Memorial Sloan Kettering Cancer Center (New York, NY) annotated 47,271 solid tumors sequenced with the MSK-IMPACT clinical assay using two temporally distinct versions of the OncKB knowledge base deployed 5 years apart. Between 2017 and 2022, there was an increase from 8.9% tot 31.6% in the fraction of tumors harboring a standard care predictive biomarker of therapy response, and an almost halving of tumors carrying non-actionable drivers (44.2% to 22.8%). In tumors with limited or no clinical actionability, TP53 (43.2%), KRAS (19.2%), and CDKN2A (12.2%) were the most frequently altered genes. The authors conclude that while clear progress has been made in expanding the availability of precision oncology-based treatment paradigms, these results suggest a continued unmet need for innovative therapeutic strategies, particularly for cancers with currently undruggable oncogenic drivers.