Implementation of a Molecular Tumor Registry to Support the Adoption of Precision Oncology Within an Academic Medical Center: The Duke University Experience.

Autor:	Green MF; Department of Pathology, Duke University Medical Center, Durham, NC., Bell JL; Department of Pathology, Duke University Medical Center, Durham, NC., Hubbard CB; Department of Pathology, Duke University Medical Center, Durham, NC., McCall SJ; Department of Pathology, Duke University Medical Center, Durham, NC., McKinney MS; Division of Hematologic Malignancies, Department of Medicine, Duke University Medical Center, Durham, NC., Riedel JE; Duke Cancer Institute, Duke University Medical Center, Durham, NC., Menendez CS; Duke Cancer Institute, Duke University Medical Center, Durham, NC.; Department of Surgery, Duke University Medical Center, Durham, NC., Abbruzzese JL; Duke Cancer Institute, Duke University Medical Center, Durham, NC.; Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC., Strickler JH; Duke Cancer Institute, Duke University Medical Center, Durham, NC.; Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, NC., Datto MB; Department of Pathology, Duke University Medical Center, Durham, NC.
Jazyk:	angličtina
Zdroj:	JCO precision oncology [JCO Precis Oncol] 2021 Sep 16; Vol. 5. Date of Electronic Publication: 2021 Sep 16 (Print Publication: 2021).
DOI:	10.1200/PO.21.00030
Abstrakt:	Comprehensive genomic profiling to inform targeted therapy selection is a central part of oncology care. However, the volume and complexity of alterations uncovered through genomic profiling make it difficult for oncologists to choose the most appropriate therapy for their patients. Here, we present a solution to this problem, The Molecular Registry of Tumors (MRT) and our Molecular Tumor Board (MTB). Patients and Methods: MRT is an internally developed system that aggregates and normalizes genomic profiling results from multiple sources. MRT serves as the foundation for our MTB, a team that reviews genomic results for all Duke University Health System cancer patients, provides notifications for targeted therapies, matches patients to biomarker-driven trials, and monitors the molecular landscape of tumors at our institution. Results: Among 215 patients reviewed by our MTB over a 6-month period, we identified 176 alterations associated with therapeutic sensitivity, 15 resistance alterations, and 51 alterations with potential germline implications. Of reviewed patients, 17% were subsequently treated with a targeted therapy. For 12 molecular therapies approved during the course of this work, we identified between two and 71 patients who could qualify for treatment based on retrospective MRT data. An analysis of 14 biomarker-driven clinical trials found that MRT successfully identified 42% of patients who ultimately enrolled. Finally, an analysis of 4,130 comprehensive genomic profiles from 3,771 patients revealed that the frequency of clinically significant therapeutic alterations varied from approximately 20% to 70% depending on the tumor type and sequencing test used. Conclusion: With robust informatics tools, such as MRT, and the right MTB structure, a precision cancer medicine program can be developed, which provides great benefit to providers and patients with cancer. (© 2021 by American Society of Clinical Oncology.)
Databáze:	MEDLINE
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