A cloud-based virtual tumor board to facilitate treatment recommendations for patients with advanced cancers.

Madhavan, Subha; Blais, Edik M.; Bender, R Joseph; Chung, Vincent; Hendifar, Andrew Eugene; Mikhail, Sameh; Lowery, Maeve A.; Sohal, Davendra; Pohlmann, Paula Raffin; Moore, Kathleen N.; He, Kai; Monk, Bradley J.; Coleman, Robert L.; Herzog, Thomas J.; Petricoin, Emanuel; Halverson, David; Pishvaian, Michael J.

doi:10.1200/jco.2018.36.15_suppl.6508

Cited by 6 publications

(7 citation statements)

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“…PRECISE is not the only system designed to address the emerging need of matching patients to relevant clinical trials on the basis of the patient’s genomic profile. Several other centers have developed strategies by which to achieve this goal that range from on-site or virtual molecular tumor boards to automated matching platforms 13 , 18 - 23 (Appendix Table A1 ). Each of these systems offers physician decision support that aims to bridge the gap between genomic alteration detection and identification of the appropriate genome-driven therapy.…”

Section: Discussionmentioning

confidence: 99%

Real-World Outcomes of an Automated Physician Support System for Genome-Driven Oncology

Tao

Eubank

Schram

et al. 2019

JCO Precision Oncology

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PURPOSE Matching patients to investigational therapies requires new tools to support physician decision making. We designed and implemented Precision Insight Support Engine (PRECISE), an automated, just-in-time, clinical-grade informatics platform to identify and dynamically track patients on the basis of molecular and clinical criteria. Real-world use of this tool was analyzed to determine whether PRECISE facilitated enrollment to early-phase, genome-driven trials. MATERIALS AND METHODS We analyzed patients who were enrolled in genome-driven, early-phase trials using PRECISE at Memorial Sloan Kettering Cancer Center between April 2014 and January 2018. Primary end point was the proportion of enrolled patients who were successfully identified using PRECISE before enrollment. Secondary end points included time from sequencing and PRECISE identification to enrollment. Reasons for a failure to identify genomically matched patients were also explored. RESULTS Data were analyzed from 41 therapeutic trials led by 19 principal investigators. In total, 755 patients were accrued to these studies during the period that PRECISE was used. PRECISE successfully identified 327 patients (43%) before enrollment. Patients were diagnosed with 29 tumor types and harbored alterations in 43 oncogenes, most commonly ERBB2 (21.3%), PIK3CA (14.1%), and BRAF (8.7%). Median time from sequencing to enrollment was 163 days (interquartile range, 66 to 357 days), and from PRECISE identification to enrollment 87 days (interquartile range, 37 to 180 days). Common reasons for failing to identify patients before enrollment included accrual on the basis of molecular alterations that did not match pre-established PRECISE genomic eligibility (140 [33%] of 428) and external sequencing not available for parsing (127 [30%] of 428). CONCLUSION PRECISE identified 43% of all patients accrued to a diverse cohort of early-phase, genome-matched studies. Purpose-built informatics platforms represent a novel and potentially effective method for matching patients to molecularly selected studies.

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Section: Discussionmentioning

confidence: 99%

Real-World Outcomes of an Automated Physician Support System for Genome-Driven Oncology

Tao

Eubank

Schram

et al. 2019

JCO Precision Oncology

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“…In this context, we launched a U.S. nationwide initiative, Know Your Tumor (KYT), a collaboration between Perthera Inc. and the Pancreatic Cancer Action Network (PanCAN), which utilizes Perthera's precision medicine system for multiomic molecular profiling of a nonselected patient population. This profiling is coupled with an analytics engine that incorporates previous treatment history and molecular-clinical evidence for biomarker therapy matching, and a cloud-based tumor board that provides a Health Insurance Portability and Accountability Act (HIPAA)-compliant portal to facilitate discussion among medical and scientific reviewers (17). The intent of the KYT program is to match patients with appropriate clinical trials and therapies based on actionable molecular anomalies, treatment history, and geographical locations.…”

Section: Introductionmentioning

confidence: 99%

Molecular Profiling of Patients with Pancreatic Cancer: Initial Results from the Know Your Tumor Initiative

Pishvaian

Bender²,

Halverson³

et al. 2018

Clinical Cancer Research

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176

146

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To broaden access to and implementation of precision medicine in the care of patients with pancreatic cancer, the Know Your Tumor (KYT) program was initiated using a turn-key precision medicine system. Patients undergo commercially available multiomic profiling to determine molecularly rationalized clinical trials and off-label therapies. Tumor samples were obtained for 640 patients from 287 academic and community practices covering 44 states. College of American Pathologists/Clinical Laboratory Improvement Amendments-accredited laboratories were used for genomic, proteomic, and phosphoprotein-based molecular profiling. Tumor samples were adequate for next-generation sequencing in 96% and IHC in 91% of patients. A tumor board reviewed the results for every patient and found actionable genomic alterations in 50% of patients (with 27% highly actionable) and actionable proteomic alterations (excluding chemopredictive markers) in 5%. Actionable alterations commonly found were in DNA repair genes ( or mutations, 8.4%) and cell-cycle genes ( or alterations, 8.1%). A subset of samples was assessed for actionable phosphoprotein markers. Among patients with highly actionable biomarkers, those who received matched therapy ( = 17) had a significantly longer median progression-free survival (PFS) than those who received unmatched therapy [ = 18; PFS = 4.1 vs. 1.9 months; HR, 0.47; 95% confidence interval (CI): 0.24-0.94; = 0.03]. A comprehensive precision medicine system can be implemented in community and academic settings, with highly actionable findings observed in over 25% of pancreatic cancers. Patients whose tumors have highly actionable alterations and receive matched therapy demonstrated significantly increased PFS. Our findings support further prospective evaluation of precision oncology in pancreatic cancer. .

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“…A study carried out at Georgetown University modeled their virtual molecular tumor boards to assess the genetic makeup, previous treatment history, and other factors for 1725 patients with cancer [ 25 ]. The team compared VMTB outcomes with reviews by 5 gastrointestinal oncologists who performed tumor board duties in a conventional manner.…”

Section: Discussionmentioning

confidence: 99%

Virtual Clinical and Precision Medicine Tumor Boards—Cloud-Based Platform–Mediated Implementation of Multidisciplinary Reviews Among Oncology Centers in the COVID-19 Era: Protocol for an Observational Study

Blasi¹,

Serretta²,

Piazza³

et al. 2021

JMIR Res Protoc

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Background Multidisciplinary tumor boards play a pivotal role in the patient-centered clinical management and in the decision-making process to provide best evidence-based, diagnostic, and therapeutic care to patients with cancer. Among the barriers to achieve an efficient multidisciplinary tumor board, lack of time and geographical distance play a major role. Therefore, the elaboration of an efficient virtual multidisciplinary tumor board (VMTB) is a key point to successfully obtain an oncology team and implement a network among health professionals and institutions. This need is stronger than ever during the COVID-19 pandemic. Objective This paper presents a research protocol for an observational study focused on exploring the structuring process and the implementation of a multi-institutional VMTB in Sicily, Italy. Other endpoints include analysis of cooperation between participants, adherence to guidelines, patients’ outcomes, and patient satisfaction. Methods This protocol encompasses a pragmatic, observational, multicenter, noninterventional, prospective trial. The study’s programmed duration is 5 years, with a half-yearly analysis of the primary and secondary objectives’ measurements. Oncology care health professionals from various oncology subspecialties at oncology departments in multiple hospitals (academic and general hospitals as well as tertiary centers and community hospitals) are involved in a nonhierarchic manner. VMTB employs an innovative, virtual, cloud-based platform to share anonymized medical data that are discussed via a videoconferencing system both satisfying security criteria and compliance with the Health Insurance Portability and Accountability Act. Results The protocol is part of a larger research project on communication and multidisciplinary collaboration in oncology units and departments spread in the Sicily region. The results of this study will particularly focus on the organization of VMTBs, involving oncology units present in different hospitals spread in the area, and creating a network to allow best patient care pathways and a hub-and-spoke relationship. The present results will also include data concerning organization skills and pitfalls, barriers, efficiency, number, and types with respect to clinical cases and customer satisfaction. Conclusions VMTB represents a unique opportunity to optimize patient management through a patient-centered approach. An efficient virtualization and data-banking system is potentially time-saving, a source for outcome data, and a detector of possible holes in the hull of clinical pathways. The observations and results from this VMTB study may hopefully be useful to design nonclinical and organizational interventions that enhance multidisciplinary decision-making in oncology. International Registered Report Identifier (IRRID) DERR1-10.2196/26220

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A cloud-based virtual tumor board to facilitate treatment recommendations for patients with advanced cancers.

Cited by 6 publications

References 0 publications

Real-World Outcomes of an Automated Physician Support System for Genome-Driven Oncology

Real-World Outcomes of an Automated Physician Support System for Genome-Driven Oncology

Molecular Profiling of Patients with Pancreatic Cancer: Initial Results from the Know Your Tumor Initiative

Virtual Clinical and Precision Medicine Tumor Boards—Cloud-Based Platform–Mediated Implementation of Multidisciplinary Reviews Among Oncology Centers in the COVID-19 Era: Protocol for an Observational Study

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