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Comment & Response
December 2018

Moving Precision Oncology Forward Amid Myths and Misconceptions

Author Affiliations
  • 1Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston
JAMA Oncol. 2018;4(12):1789-1790. doi:10.1001/jamaoncol.2018.5067

To the Editor The article by Marquart et al1 is a clarion call for the strategic application of genome therapies. The study includes patients with metastatic cancer who were eligible for genomic therapy from 2006 through 2018 and concludes that the number of patients eligible for these therapies has increased over time. This increase in eligibility coincides with increasing costs; the price of the chimeric antigen receptor T-cell–based genome therapy Kymriah (Novartis) is $475 000, which restricts public accessibility. Many of these genome therapies lack information about adverse effects or long-term efficacy and have been approved on the basis of single-arm uncontrolled studies with response rates 10% to 20% higher than those reported in subsequent studies or in real-world experience.1 Marquart et al1 report that clinical benefits associated with genome therapies were seen in a minority of patients, and the estimated percentage of patients who would have benefited in 2018 did not exceed 4.41%.