This observational study aims to assess the outcomes in patients with advanced treatment refractory cancers with matched molecular/precision therapy as per their molecular profiling results after discussion at molecular tumour board.
1. To standardize response assessment and data collection for patients that are receiving off-label or non-standard therapies based on MTB recommendations.
\- Establish a standardized response assessment process and data collection patients that are receiving off-label or non-standard therapies based on MTB recommendations. 2. To demonstrate that it is feasible to standardize investigations and endpoints in this proof-of-concept study.
* Through standard safety laboratory investigations (FBC, U/E/Cr, LFT) * Through standard radiological imaging at 6-12 weeks with the key endpoint being best response during that imaging window, and disease control rate at 6 months.
Hypothesis: Our proposed IMPACT-INSPIRE study hypothesis is that standardised response assessment and data collection in patients with no available therapies receiving off-label systemic therapies, can provide a novel mechanism to assess oncological outcomes in this unique cohort of patients, generate hypothesis, and provide insights to future biomarker-driven drug development
Is equal to or greater than 21 years of age;
Histologic or cytologic confirmed advanced solid tumours;
Patients who have received and failed all standard anticancer therapy (if available) or are unsuitable for further standard anticancer therapy. Cancers with a poor prognosis or low expected response rate to standard treatment (as judged by the investigator on the basis of available evidence) may be screened with respect to an earlier line of treatment;
Ability to understand and the willingness to provide written informed consent.
Specific contraindications to exposure to the off-label or non-standard therapy (as defined by the product label);
Other comorbid conditions that may compromise assessing key outcomes or, in the judgement of the clinician, limit the ability of the patient to comply with the protocol.
Histologic or cytologic confirmation confirmed of advanced refractory solid tumours with no further suitable treatment options.
Cohort
Prospective
Off-label or non-standard systemic therapies
Other interventionOff-label systemic treatments and/or relevant clinical trials recommended by the NCCS Molecular Tumour Board (MTB).
Best objective response rate at 12 weeks
The percentage of participants with best overall response of complete response (CR) or partial response (PR).
Tumour growth rate inhibition
Duration that patient is on experimental therapy as a fraction of the total duration on last line of therapy.
Incidence of adverse events (AEs), Identified and graded using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 criteria.
Quality of life thorough AE evaluation or equivalent instruments such as the EORTC QLQ-C30 questionnaire.
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National Cancer Centre, Singapore
Lead sponsor
SingHealth Duke-NUS Academic Medical Centre
Collaborator
