Implementation and Outcomes of a Molecular Tumor Board at Herbert-Herman Cancer Center, Sparrow Hospital

Abstract

<p><strong>Objective. </strong>This paper describes our experience and outcomes from 54 cases presented to the (Molecular tumor board) MTB.</p><p><strong>Methods. </strong>54 Cases presented between July 2017 and April 2018 were included in this analysis. These patients had different types of cancers that had either failed standard therapy or were expected to fail and physicians were looking for future options for anticipated progression. Patients who had obvious mutations and were candidates for Targeted Agent and Profiling Utilization Registry or Molecular Analysis for Treatment Choice clinical trials were not included. Oncologists presented the cases virtually and Foundation Medicine scientific and clinical team discussed the molecular pathways to find targeted options or trials. Tumor board attendees included oncologists, nurses, pharmacists, mid-level providers, residents and staff of the Cancer Center.</p><p><strong>Results. </strong>Amongst the 54 cases presented 81% had one or more potentially actionable alteration. 12 (22%) patients received genomically matched therapy as per MTB recommendations. Additional 13 (24%) patients have options available when they progress. Out of 12 patients who got treatment six are alive at the time of this analysis<strong>. </strong>Genomically matched therapy or Clinical Trials option were offered to the 46% of patients based on the MTB discussion.</p><p><strong>Conclusion. </strong>More widespread use of molecular diagnostics, better physician education and multidisciplinary collaboration between the staff involved in diagnosis and treatment, as well as third party payers are necessary for consensus on treatment and care of oncology patients.</p>

Clinical and analytical validation of FoundationOne®CDx, a comprehensive genomic profiling assay for solid tumors

“…F1CDx is an FDA-approved NGS-based in vitro diagnostic device that targets 324 cancer-related genes. F1CDx is performed exclusively by Foundation Medicine as a central laboratory testing service using DNA extracted from FFPE tumor samples from cancer patients [ 63 ]. The laboratory components are performed within Foundation Medicine’s College of American Pathologists (CAP)-accredited laboratory that has been certified by CMS pursuant to CMS procedures for the certification of international laboratories in accordance with CLIA.…”

“…Each specimen is reviewed by a licensed pathologist for tumor purity, suitability, and consistency with the stated diagnosis when provided, another crucial step in ensuring quality. Other Foundation Medicine decision support includes provision of molecular tumor board (MTB) services [ 63 , 119 , 120 ], allowing clinicians to tap the wealth of knowledge that a team of expert genomicists, pathologists, and oncologists provides. In a study assessing the impact of the Foundation Medicine MTB program, of 54 cases presented, 81% had one or more potentially therapeutically relevant alterations, and genomically-matched therapy or clinical trial options were offered to 46% of patients based on the MTB discussion [ 63 ].…”

“…Other Foundation Medicine decision support includes provision of molecular tumor board (MTB) services [ 63 , 119 , 120 ], allowing clinicians to tap the wealth of knowledge that a team of expert genomicists, pathologists, and oncologists provides. In a study assessing the impact of the Foundation Medicine MTB program, of 54 cases presented, 81% had one or more potentially therapeutically relevant alterations, and genomically-matched therapy or clinical trial options were offered to 46% of patients based on the MTB discussion [ 63 ]. A well-curated gene list has also allowed for review of recent results to inform physicians and patients of newly approved therapies for which their patients may be eligible.…”

Precision medicine‐based therapies in advanced colorectal cancer: The University of California San Diego Molecular Tumor Board experience

“…However, other MTBs treating various solid and hematologic cancers have shown objective response rates from 0-13% [28,29]. In the case of CRC, the use of an MTB to match molecularly targeted regimens to patients has recently shown improved outcomes in patients with metastatic CRC [30].…”

Implementation of a molecular tumour board in LATAM: the impact on treatment decisions for patients evaluated at Instituto Alexander Fleming, Argentina

“…This approach can only be carried out by a multidisciplinary team with a comprehensive molecular vision: the molecular tumour board (MTB). The role of the MTB is to recommend personalised therapy for patients with cancer beyond standard-of-care treatment [ 15 ]. A comprehensive molecular analysis of the tumour in a molecular pathology laboratory is important for all targeted therapies approaches.…”