Transitioning the Molecular Tumor Board from Proof of Concept to Clinical Routine: A German Single-Center Analysis

Autor: Anna Lena Illert, Nikolas von Bubnoff, Rouven Hoefflin, Michel Eisenblaetter, Philipp Poxleitner, Patrick Metzger, Nico Buettner, Florian Scherer, Anna-Lena Geißler, Alexander Keller, Melanie Boerries, Alexandra Kutilina, Ralph Fritsch, Christine Dierks, Jesus Duque-Afonso, Adriana Lazarou, Isabell Xiang Ge, Justus Duyster, Steffen Heeg, Frank Meiss, Andreas Tzschach, Anna Verena Frey, Cornelius Miething, Gian Kayser, Simone Hettmer, Martin Werner, Leman Mehmed, Heiko Becker, Justyna Rawluk, Julius Wehrle, Dieter Henrik Heiland, Khalid Shoumariyeh, Markus Grabbert, Tilman Brummer, Juri Ruf, Thalia Erbes, Christoph Peters, Konrad Aumann, Kai Berner, Maria Elena Hess, Meike Reiser, Martin Boeker, Anita Kleiber, Silke Lassmann, Henning Schäfer
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Cancers
Volume 13
Issue 5
Cancers, Vol 13, Iss 1151, p 1151 (2021)
ISSN: 2072-6694
DOI: 10.3390/cancers13051151
Popis: Simple Summary Access to molecular cancer treatments outside of clinical trials is limited and the benefit of molecular-guided, individualized patient care in patients with cancer progression after standard treatment is unclear. We here present the four-year experience of one of Europe’s first Molecular Tumor Boards and show that precision oncology in the era of affordable, extended genetic and phenotypic tumor profiling is feasible and effective for a small but relevant proportion of advanced cancer patients. We performed a comprehensive analysis of clinical follow-up data and report our workflow optimizations and upscaling processes. These could help other centers to establish similar structures to support molecular-guided treatment for patients with limited therapy options. Abstract Molecular precision oncology faces two major challenges: first, to identify relevant and actionable molecular variants in a rapidly changing field and second, to provide access to a broad patient population. Here, we report a four-year experience of the Molecular Tumor Board (MTB) of the Comprehensive Cancer Center Freiburg (Germany) including workflows and process optimizations. This retrospective single-center study includes data on 488 patients enrolled in the MTB from February 2015 through December 2018. Recommendations include individual molecular diagnostics, molecular stratified therapies, assessment of treatment adherence and patient outcomes including overall survival. The majority of MTB patients presented with stage IV oncologic malignancies (90.6%) and underwent an average of 2.1 previous lines of therapy. Individual diagnostic recommendations were given to 487 patients (99.8%). A treatment recommendation was given in 264 of all cases (54.1%) which included a molecularly matched treatment in 212 patients (43.4%). The 264 treatment recommendations were implemented in 76 patients (28.8%). Stable disease was observed in 19 patients (25.0%), 17 had partial response (22.4%) and five showed a complete remission (6.6%). An objective response was achieved in 28.9% of cases with implemented recommendations and for 4.5% of the total population (22 of 488 patients). By optimizing the MTB workflow, case-discussions per session increased significantly while treatment adherence and outcome remained stable over time. Our data demonstrate the feasibility and effectiveness of molecular-guided personalized therapy for cancer patients in a clinical routine setting showing a low but robust and durable disease control rate over time.
Databáze: OpenAIRE
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