MSKCC Launches Center for Molecular Oncology

Memorial Sloan Kettering Cancer Center (MSKCC) in New York, NY, launched in May the Center for Molecular Oncology (CMO), a program its leaders say will deliver personalized treatment options to more cancer patients.

Established with a $100 million gift from Marie-Josée and Henry R. Kravis, the CMO expands the ability to perform genetic profiling in the clinic beyond cancers such as lung and colon for which profiling is standard of care, says CMO director David Solit, MD. “The center will allow us to offer genetic testing for cancers such as bladder, prostate, ovarian, endometrial, and many others where it is not currently part of routine care,” he says.

The center plans to genetically profile the tumors from every patient with metastatic disease at MSKCC, totaling more than 10,000 patients each year. Solit says the long-term goal is to also analyze the tumors of patients with earlier-stage disease.

Hundreds of tumors have already been analyzed using a test that can screen for mutations in 341 cancer-associated genes. Even in cancers for which genetic profiling is now standard, only a handful of genes are typically sequenced, Solit says.

Some patients are then matched with approved cancer drugs that target the mutations fueling their tumors. Others are enrolled in clinical trials called basket studies that use agents targeted to a specific mutation, regardless of cancer type. Basket studies allow patients with a driver mutation that has not yet been studied in their tumor type to receive a targeted agent.

The center has several basket studies currently under way, Solit notes. One is testing neratinib (PB272; Puma Biotechnology) in patients with a HER2 or HER3 mutation, while another is using vemurafenib (Zelboraf; Genentech) in patients with a BRAF mutation. “We have already observed some dramatic responses on these basket studies,” he says.

Another CMO initiative uses MSKCC's extensive collection of tumor samples to discover new mutations and drug targets. Researchers are, for example, retrospectively analyzing tumors of exceptional responders, patients who had a sustained response to a treatment in a clinical trial in which nearly all other participants did not.

Solit recently discovered that a mutation in TSC1 was responsible for an advanced bladder cancer patient's remarkable response to everolimus (Afinitor; Novartis), a targeted drug approved for kidney cancer. Solit is now finalizing plans for a basket study to test everolimus in patients whose tumors test positive for a TSC1 mutation.

MSKCC is not alone in its quest to bring the genomic revolution into patient care. Earlier this year, San Diego, CA–based Human Longevity Inc. launched a similar effort to understand the molecular underpinnings of cancer and other diseases, as did the Broad Institute of MIT and Harvard in 2004.

What sets the CMO apart is its ability to apply molecular insights in real time to guide clinical practice. “Most of the sequencing that's been reported to date has been performed as part of retrospective studies,” Solit says. “The CMO will use next-generation methods to prospectively profile patients who are actively receiving treatment in the clinic now.

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