319 Gynecologic malignancies in the era of precision medicine

Introduction/Background* Personalized medicine is replacing the classical one-size-fits-all traditional oncology approaches tailoring the most appropriate therapy for each patient. Molecular and genomic profiling diagnostic tools are implementing patients’ journey. Methodology This is a single centre prospective study performed from January 2020 and April 2021 at Fondazione IRCCS Istituto Nazionale dei Tumori di Milano (Italy). All consecutive, heavily pretreated patients, for whom effective conventional treatments were not available, were enrolled in this study and underwent molecular and genomic profiling via Foundation One CDx test. Result(s)* Overall, 63 heavily pretreated patients had Foundation One CDx test. We identified 10 patients (16%) with mutation or genetic signatures candidate to use personalized therapy (table 1). Out of 10 patients, 4 are patients affected by cervical, 4 by endometrial and the remnant are affected by ovarian carcinoma. Actually 1 patient is receiving immunotherapy with atezolizumab plus anti-ICOS and 1 is undergoing evaluation in order to start same drugs; 2 patients with ovarian cancer had BRAF/V600E mutations and are ongoing on treatment with trametinib +/- dabrafenib; 2 patients with cervical cancer had PI3KCA mutations and are treating with alpelisib. Furthermore, in 4 patients an actionable mutation was found but standard chemotherapeutic treatment is still ongoing (table 2). Immunotherapy and target therapy are administered into the clinical trial or thank to compassionate use. Conclusion* Molecular and genomic profiling of gynecological malignancies is not clinical practice. We demonstrated that in this population identified alterations, by genetic driver, could help to find a new therapeutically opportunity. This allows to identify predictive biomarkers for target therapies in order to offer new therapeutic prospective for our gynecologic patients.