Clinical decisions by the molecular tumor board on comprehensive genomic profiling tests in Japan: A retrospective observational study.

Autor: Shirota H; Department of Clinical Oncology, Tohoku University Hospital, Sendai, Japan., Komine K; Department of Clinical Oncology, Tohoku University Hospital, Sendai, Japan., Takahashi M; Department of Clinical Oncology, Tohoku University Hospital, Sendai, Japan., Takahashi S; Department of Clinical Oncology, Tohoku University Hospital, Sendai, Japan., Miyauchi E; Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan., Niizuma H; Department of Pediatrics, Tohoku University School of Medicine, Sendai, Japan., Tada H; Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan., Shimada M; Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan., Niihori T; Department of Medical Genetics, Tohoku University Graduate School of Medicine, Sendai, Japan., Aoki Y; Department of Medical Genetics, Tohoku University Graduate School of Medicine, Sendai, Japan., Sugiyama I; Personalized Medicine Center, Tohoku University Hospital, Sendai, Japan., Kawamura M; Personalized Medicine Center, Tohoku University Hospital, Sendai, Japan., Yasuda J; Division of Molecular Cellular Oncology, Miyagi Cancer Center Research Institute, Natori, Japan., Suzuki S; Department of Clinical Oncology, Yamagata University Faculty of Medicine, Yamagata, Japan., Iwaya T; Molecular Therapeutics Laboratory, Department of Surgery, Iwate Medical University School of Medicine, Morioka, Japan., Saito M; Department of Gastrointestinal Tract Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan., Saito T; Department of Breast Surgery, Japanese Red Cross Saitama Hospital, Saitama, Japan., Shibata H; Department of Clinical Oncology, Graduate School of Medicine, Akita University, Akita, Japan., Furukawa T; Department of Investigative Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan., Ishioka C; Department of Clinical Oncology, Tohoku University Hospital, Sendai, Japan.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2023 Mar; Vol. 12 (5), pp. 6170-6181. Date of Electronic Publication: 2022 Oct 17.
DOI: 10.1002/cam4.5349
Abstrakt: Background: A paradigm shift has occurred in cancer chemotherapy from tumor-specific treatment with cytotoxic agents to personalized medicine with molecular-targeted drugs. Thus, it is essential to identify genomic alterations and molecular features to recommend effective targeted molecular medicines regardless of the tumor site. Nevertheless, it takes considerable expertise to identify treatment targets from primary-sequencing data in order to provide drug recommendations. The Molecular Tumor Board (MTB) denotes a platform that integrates clinical and molecular features for clinical decisions.
Methods: This study retrospectively analyses all the cases of discussion and decision at the MTB in Tohoku University Hospital and summarizes genetic alterations and treatment recommendations.
Results: The MTB discussed 1003 comprehensive genomic profiling (CGP) tests conducted in patients with solid cancer, and the resulting rate of assessing treatment recommendations was approximately 19%. Among hundreds of genes in the CGP test, only 30 genetic alterations or biomarkers were used to make treatment recommendations. The leading biomarkers that led to treatment recommendations were tumor mutational burden-high (TMB-H) (n = 32), ERBB2 amplification (n = 24), BRAF V600E (n = 16), and BRCA1/2 alterations (n = 32). Thyroid cancer accounted for most cancer cases for which treatment recommendation was provided (81.3%), followed by non-small cell lung cancer (42.4%) and urologic cancer (31.3%). The number of tests performed for gastrointestinal cancers was high (n = 359); however, the treatment recommendations for the same were below average (13%).
Conclusion: The results of this study may be used to simplify treatment recommendations from the CGP reports and help select patients for testing, thereby increasing the accuracy of personalized medicine.
(© 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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