TARGETED cancer treatment options should become more simplified and standardised following the creation of a new scale for tumour DNA mutations that has been agreed by leading cancer specialists in Europe and North America. It is hoped that ESMO Scale for Clinical Actionability of molecular Targets (ESCAT) will improve outcomes in cancer therapy by identifying those patients who are likely to respond to available precision medicines.
Optimal Treatment Choice
“Doctors receive a growing amount of information about the genetic make-up of each patient’s cancer, but this can be difficult to interpret for making optimal treatment choices,” commented Prof Fabrice André, Chair of the ESMO Translational Research and Precision Medicine Working Group. “The new scale will help us distinguish between alterations in tumour DNA that are important for decisions about targeted medicines or access to clinical trials, and those which aren’t relevant.”
ESCAT Tool
Using the latest clinical evidence, the ESCAT grades alterations in tumour DNA according to their relevance as markers for selecting patients for targeted treatment on a tier system ranging from I–V. The new classification for the first time takes into account all potential targeted cancer medicines and not just those that have been approved for use in national regulatory bodies.
“For the first time, ESMO has created the tools to make it clear what data are needed for a mutation to be considered actionable and how this may change in response to new clinical data,” explained lead author Dr Joaquin Mateo, Vall d’Hebron Institute of Oncology, Barcelona, Spain. “The scale focusses on the clinical evidence for matching tumour mutations with the drugs we have in our clinics and gives us a common vocabulary for communication between clinicians, and for explaining potential treatment benefits to patients.”
It is hoped that the inclusion of this grading system of genomic mutations in clinical and laboratory reports will become routine practice in the future, clearly outlining which mutations need to be prioritised.
Improving Patient Engagement
The scale should also help patients to better understand why their doctor has recommended a particular treatment, improving their engagement. In particular, it should become easier for patients to discuss the results of multigene sequencing with their doctor.
James Coker, Reporter
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