%0 Journal Article
%T Addressing the knowledge gap in the genomic landscape and tailored therapeutic approaches to adolescent and young adult cancers.
%A Hayashi N
%A Ono M
%A Fukada I
%A Yamazaki M
%A Sato N
%A Hosonaga M
%A Wang X
%A Kaneko K
%A Arakawa H
%A Habano E
%A Kuga A
%A Kataoka A
%A Ueki A
%A Kiyotani K
%A Tonooka A
%A Takeuchi K
%A Kogawa T
%A Kitano S
%A Takano T
%A Watanabe M
%A Mori S
%A Takahashi S
%J ESMO Open
%V 9
%N 8
%D 2024 Aug 12
%M 39137480
%F 6.883
%R 10.1016/j.esmoop.2024.103659
%X <B>BACKGROUND: </B>Adolescents and young adults (AYAs) represent a small proportion of patients with cancer. The genomic profiles of AYA patients with cancer are not well-studied, and outcomes of genome-matched therapies remain largely unknown.<BR><B>METHODS: </B>We investigated differences between Japanese AYA and older adult (OA) patients in genomic alterations, therapeutic evidence levels, and genome-matched therapy usage by cancer type. We also assessed treatment outcomes.<BR><B>RESULTS: </B>AYA patients accounted for 8.3% of 876 cases. Microsatellite instability-high and/or tumor mutation burden was less common in AYA patients (1.4% versus 7.7% in OA; P = 0.05). However, BRCA1 alterations were more common in AYA patients with breast cancer (27.3% versus 1.7% in OA; P = 0.01), as were MYC alterations in AYA patients with colorectal cancer (23.5% versus 5.8% in OA; P = 0.02) and sarcoma (31.3% versus 3.4% in OA; P = 0.01). Genome-matched therapy use was similar between groups, with overall survival tending to improve in both. However, in AYA patients, the small number of patients prevented statistical significance. Comprehensive genomic profiling-guided genome-matched therapy yielded encouraging results, with progression-free survival of 9.0 months in AYA versus 3.7 months in OA patients (P = 0.59).<BR><B>CONCLUSIONS: </B>Our study suggests that tailored therapeutic approaches can benefit cancer patients regardless of age.