Implementation of a Molecular Tumor Board: The Impact on Treatment Decisions for 35 Patients Evaluated at Dartmouth-Hitchcock Medical Center

Tafe, Laura J.; Gorlov, Ivan P.; Abreu, Francine B. de; Lefferts, Joel A.; Li, Xiaoying; Pettus, Jason R.; Marotti, Jonathan D.; Bloch, Kasia J.; Memoli, Vincent A.; Suriawinata, Arief A.; Dragnev, Konstantin H.; Fadul, Camilo E.; Schwartz, Gary N.; Morgan, Clinton R.; Holderness, Britt M.; Peterson, Julie; Tsongalis, Gregory J.; Miller, Todd W.; Chamberlin, Mary D.

doi:10.1634/theoncologist.2015-0097

Cited by 84 publications

(80 citation statements)

References 30 publications

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“…Among 50 patients, the MTB recommended therapy for 29 patients and only 9 received this therapy. In a similar report from the Dartmouth hospital in Lebanon, only 25% of patients received the treatment recommended by the MTB [29]. In the San Diego Moores Cancer Center, NGS analyses affected the cancer treatment in 35.3% of cases [30].…”

Section: Discussionmentioning

confidence: 95%

“…However, the integration of such technology in a practical, efficient, and value-added manner is not straightforward. Some reports are upcoming for American hospitals involving small and heterogenous population of patients with different cancer location [27][28][29][30][31]. While many clinical trials on this subject are in progress in European countries, no European hospital has reported their experience with such strategy in a daily clinical practice.…”

Section: Discussionmentioning

confidence: 99%

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Use of dedicated gene panel sequencing using next generation sequencing to improve the personalized care of lung cancer.

Kaderbhai

Ghiringhelli

Boidot

et al. 2016

JCO

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Advances in Next Generation Sequencing (NGS) technologies have improved the ability to detect potentially targetable mutations. However, the integration of NGS into clinical management in an individualized manner remains challenging. In this single-center observational study, we performed a dedicated NGS panel studying 41 cancer-related genes in 50 consecutive patients with metastatic non-small-cell lung cancer between May 2012 and October 2014. Molecular analysis could be performed in 48 patients with a good quality check. One hundred and thirty-three mutations, whose twenty-four unique mutations, were detected. At least one mutation was found in 46 patients. In 58% of cases, the Molecular Tumor Board (MTB) was able to recommend treatment with a targeted agent based on the evaluation of the tumor genetic profile and treatment history. Nine patients (18%) were subsequently treated with a MTBrecommended targeted therapy; four patients experienced a clinical benefit with a partial response or stabilization lasting more than 4 months. In this case series involving patients with metastatic non-small cell lung cancer, we show that including integrative clinical sequencing data into routine clinical management was feasible and could impact on patient therapeutic proposal.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Use of dedicated gene panel sequencing using next generation sequencing to improve the personalized care of lung cancer.

Kaderbhai

Ghiringhelli

Boidot

et al. 2016

JCO

View full text Add to dashboard Cite

show abstract

“…Given the complex issues involved in interpreting these data sets, some institutions have adopted a ''molecular tumor board'' approach to facilitate multidisciplinary decision-making. [53][54][55] Although tumor profiling may reveal intriguing molecular targets for specific breast cancers and for breast cancer in general, current standards of care are not predicated on the results of NGS assays.…”

Section: Discussionmentioning

confidence: 99%

Molecular Testing in Breast Cancer: A Guide to Current Practices

Hagemann

2016

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Molecular diagnostics play a role in the management of many cancers, including breast cancer.Objective.-To provide an update on molecular testing in current clinical practice, targeted at practicing pathologists who are not breast cancer specialists.Data Sources.-This study is a narrative literature review.Conclusions.-In addition to routine hormone (estrogen and progesterone) receptor testing, new and recurrent tumors are tested for HER2 amplification by in situ hybridization or overexpression by immunohistochemistry. Intrinsic subtyping of tumors represents a fundamental advance in our understanding of breast cancer biology, but currently it has an indirect role in patient management. Clinical next-generation sequencing (tumor profiling) is increasingly used to identify potentially actionable mutations in tumor tissue. Multianalyte assays with algorithmic analysis, including MammaPrint, Oncotype DX, and Prosigna, play a larger role in breast cancer than in many other malignancies. Given that a proportion of breast cancers are familial, testing of nontumor tissue for cancer predisposition mutations also plays a role in breast cancer care.

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“…With this regard, as the clinical utility of comprehensive genomic profiling is just beginning to be evaluated, the number of publications reporting the clinical utility of comprehensive genomic profiling in cancer patients is still limited. Notwithstanding this, several previous studies have reported that comprehensive genomic profiling provided clinical benefit for patients with various advanced cancers (71)(72)(73)(74)(75). In a recent study by Tsimberidou et al (73), the overall survival of patients who received matched therapy was significantly longer than that of patients who did not received matched therapy (median, 11.4 vs. 8.6 months; P = 0.04).…”

Section: Clinical Utility Of Comprehensive Genomic Profilingmentioning

confidence: 99%

The possibility of clinical sequencing in the management of cancer

Kou

Kanai

Matsumoto

et al. 2016

Jpn. J. Clin. Oncol.

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Comprehensive genomic profiling using next-generation sequencing technologies provides insights into understanding the genomic architecture of human cancer. This new understanding of the cancer genome allows us to identify many more genomic alterations occurring within tumors than before, some of which could be potential therapeutic targets through molecular targeted agents. Currently, a large number of molecular targeted agents are being developed, and consequently, cancer treatment is rapidly shifting from empiric therapy employing cytotoxic anticancer drugs to genotypedirected therapy using molecular targeted agents. In current daily clinical practice, hotspot-based single-gene assays that detect RAS mutations in colorectal cancer or EGFR mutations in non-small cell lung cancer are widely used to identify variants. However, it is becoming evident that more comprehensive genomic analysis is crucial in identifying the patient population that may benefit from molecular targeted therapy and the accelerated development of novel drugs for early clinical trials. For these purposes, an increasing number of gene panel-based targeted sequencing is commercially available in clinical practice from sequencing companies. Despite several challenges in implementing this approach, comprehensive genomic profiling and identification of actionable mutations is likely to become one of the standard options in the management of cancer in the near future. The use of clinical sequencing has the potential to usher a new era in precision medicine for cancer diagnosis and treatment. In this review, we discuss the application of comprehensive genomic profiling using next-generation sequencing technologies in clinical oncology and address the current challenges for its implementation.

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Implementation of a Molecular Tumor Board: The Impact on Treatment Decisions for 35 Patients Evaluated at Dartmouth-Hitchcock Medical Center

Cited by 84 publications

References 30 publications

Use of dedicated gene panel sequencing using next generation sequencing to improve the personalized care of lung cancer.

Use of dedicated gene panel sequencing using next generation sequencing to improve the personalized care of lung cancer.

Molecular Testing in Breast Cancer: A Guide to Current Practices

The possibility of clinical sequencing in the management of cancer

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