Multidisciplinary molecular tumour board: a tool to improve clinical practice and selection accrual for clinical trials in cancer patients

Rolfo, Christian; Coelho, Ana Rita; Dam, Peter van; Dendooven, Amélie; Weyn, Christine; Rasschaert, Marika; Houten, L. Van; Trinh, B; Meerbeeck, Jan P. van; Pauwels, Patrick; Peeters, Marc

doi:10.1093/annonc/mdw363.03

Cited by 32 publications

(43 citation statements)

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“…They examine each patient's clinical, pathologic, and molecular information, review the literature and available resources, carry out discussions to reach a consensus if possible, and make treatment suggestions [89]. Previous studies have shown that interdisciplinary tumor boards can result in significant changes in treatment decisions [90][91][92][93]. The impact of MTB on outcomes has not yet been studied indepth, but they can help to identify patients for clinical trials, educate participants, facilitate collaboration, and ensure that providers across multiple locations are testing and treating patients in a uniform and consistent manner, based on clinical practice guidelines and best available evidence.…”

Section: Molecular Tumor Boardmentioning

confidence: 99%

“…There are various challenges to implementing a successful MTB; for instance, it is not always possible for members to meet in person, the MTB may not always be accessible by community oncologists, and there is a lack of standard quality requirements and guidelines on how to run an MTB and make treatment decisions [90]. A solution to some of these issues is the use of virtual MTB.…”

Section: Molecular Tumor Boardmentioning

confidence: 99%

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Molecular profiling for precision cancer therapies

et al. 2020

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The number of druggable tumor-specific molecular aberrations has grown substantially in the past decade, with a significant survival benefit obtained from biomarker matching therapies in several cancer types. Molecular pathology has therefore become fundamental not only to inform on tumor diagnosis and prognosis but also to drive therapeutic decisions in daily practice. The introduction of next-generation sequencing technologies and the rising number of large-scale tumor molecular profiling programs across institutions worldwide have revolutionized the field of precision oncology. As comprehensive genomic analyses become increasingly available in both clinical and research settings, healthcare professionals are faced with the complex tasks of result interpretation and translation. This review summarizes the current and upcoming approaches to implement precision cancer medicine, highlighting the challenges and potential solutions to facilitate the interpretation and to maximize the clinical utility of molecular profiling results. We describe novel molecular characterization strategies beyond tumor DNA sequencing, such as transcriptomics, immunophenotyping, epigenetic profiling, and single-cell analyses. We also review current and potential applications of liquid biopsies to evaluate blood-based biomarkers, such as circulating tumor cells and circulating nucleic acids. Last, lessons learned from the existing limitations of genotype-derived therapies provide insights into ways to expand precision medicine beyond genomics.

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Section: Molecular Tumor Boardmentioning

confidence: 99%

Section: Molecular Tumor Boardmentioning

confidence: 99%

Molecular profiling for precision cancer therapies

et al. 2020

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“…Although these laboratories usually self‐proclaim that they have accurately detected tumor‐specific alterations with high clinical sensitivity and specificity and have comprehensively reported the latest medication information, the authenticity and reliability of the clinical ctDNA analysis report is still doubtful . As accurate, comprehensive, and standardized test reports serve as the cornerstone for clinicians to identify the best treatment strategies for patients with cancer, the existing inconsistent reports have made this a challenging time for clinicians to exactly fathom out the reliable reports and effectively incorporate these reports into routine patient care .…”

Section: Introductionmentioning

confidence: 99%

“…To address this situation, a multidisciplinary molecular tumor board (MTB) has been proposed that brings together clinicians, pathologists, geneticists, molecular biologists, and bioinformaticians to assess appropriate tumor profiling and to discuss acceptable therapeutic options for patients. However, owing to the low penetration rate, the low level of patient coverage, and the long lead time for gathering experts, MTB is not currently a viable option .…”

Section: Introductionmentioning

confidence: 99%

From Somatic Variants Toward Precision Oncology: An Investigation of Reporting Practice for Next-Generation Sequencing-Based Circulating Tumor DNA Analysis

et al. 2019

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Background With the accelerated development of next‐generation sequencing (NGS), identified variants, and targeted therapies, clinicians who confront the complicated and multifarious genetic information may not effectively incorporate NGS‐based circulating tumor DNA (ctDNA) analysis into routine patient care. Consequently, standardized ctDNA testing reports are of vital importance. In an effort to guarantee high‐quality reporting performance, we conducted an investigation of the current detection and reporting practices for NGS‐based ctDNA analysis. Materials and Methods A set of simulated ctDNA samples with known variants at known allelic frequencies and a corresponding case scenario were distributed to 66 genetic testing laboratories for ctDNA analysis. Written reports were collected to evaluate the detection accuracy, reporting integrity, and information sufficiency using 21 predefined criteria. Results Current reporting practices for NGS‐based ctDNA analysis were found to be far from satisfactory, especially regarding testing interpretation and methodological details. Only 42.4% of laboratories reported the results in complete concordance with the expected results. Moreover, 74.2% of reports only listed aberrations with direct and well‐known treatment consequences for the tumor type in question. Genetic aberrations for which experimental agents and/or drug access programs are available may thus be overlooked. Furthermore, methodological details for the interpretation of results were missing from the majority of reports (87.9%). Conclusion This proof‐of‐principle study suggests that the capacity for accurate identification of variants, rational interpretation of genotypes, comprehensive recommendation of potential medications, and detailed description of methodologies need to be further improved before ctDNA analysis can be formally implemented in the clinic. Implications for Practice Accurate, comprehensive, and standardized clinical sequencing reports can help to translate complex genetic information into patient‐centered clinical decisions, thereby shepherding precision oncology into daily practice. However, standards, guidelines, and quality requirements for clinical reports of next‐generation sequencing (NGS)‐based circulating tumor DNA (ctDNA) analysis are currently absent. By using a set of simulated clinical ctDNA samples and a corresponding case scenario, current practices were evaluated to identify deficiencies in clinical sequencing reports of ctDNA analysis. The recommendations provided here may serve as a roadmap for the improved implementation of NGS‐based ctDNA analysis in the clinic.

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“…Genomic and molecular characterisation of tumours including liquid biopsy measurements is now clinically applied. A recent ESMO report describes the "multidisciplinary molecular tumour board" as a tool to improve clinical practice and selection accrual for clinical trials in patients with cancer [14]. This report indicates that the creation of molecular tumour boards for patient selection and assessment of treatment options is a result of the complexity of delivering precision medicine to cancer patients.…”

mentioning

confidence: 99%