PURPOSE: Tumor genomic profiling for personalized oncology therapy is being widely applied in clinical practice even as it is being evaluated more formally in clinical trials. Given the complexities of genomic data and its application to clinical use, molecular tumor boards with diverse expertise can provide guidance to oncologists and patients seeking to implement personalized genetically targeted therapy in practice. METHODS: A multidisciplinary molecular tumor board reviewed tumor molecular profiling reports from consecutive referrals at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins over a 3-year period. The tumor board weighed evidence for actionability of genomic alterations identified by molecular profiling and provided recommendations including US Food and Drug Administration-approved drug therapy, clinical trials of matched targeted therapy, off-label use of such therapy, and additional tumor or germline genetic testing. RESULTS: One hundred fifty-five patients were reviewed. Actionable genomic alterations were identified in 132 patients (85%). Off-label therapies were recommended in 37 patients (24%). Eleven patients were treated off-label, and 13 patients were enrolled onto clinical trials of matched targeted therapies. Median progression-free survival of patients treated with matched therapies was 5 months (95% CI, 2.9 months to not reached), and the progression-free survival probability at 6 months was 43%(95% CI, 26% to 71%). Lack of locally available clinical trials was the major limitation on clinical actionability of tumor profiling reports. CONCLUSION: The molecular tumor board recommended off-label targeted therapies for a quarter of all patients reviewed. Outcomes were heterogeneous, although 43% of patients receiving genomically matched therapy derived clinical benefit lasting at least 6 months. Until more data become available from precision oncology trials, molecular tumor boards can help guide appropriate use of tumor molecular testing to direct therapy.
PURPOSE: Tumor genomic profiling for personalized oncology therapy is being widely applied in clinical practice even as it is being evaluated more formally in clinical trials. Given the complexities of genomic data and its application to clinical use, molecular tumor boards with diverse expertise can provide guidance to oncologists and patients seeking to implement personalized genetically targeted therapy in practice. METHODS: A multidisciplinary molecular tumor board reviewed tumor molecular profiling reports from consecutive referrals at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins over a 3-year period. The tumor board weighed evidence for actionability of genomic alterations identified by molecular profiling and provided recommendations including US Food and Drug Administration-approved drug therapy, clinical trials of matched targeted therapy, off-label use of such therapy, and additional tumor or germline genetic testing. RESULTS: One hundred fifty-five patients were reviewed. Actionable genomic alterations were identified in 132 patients (85%). Off-label therapies were recommended in 37 patients (24%). Eleven patients were treated off-label, and 13 patients were enrolled onto clinical trials of matched targeted therapies. Median progression-free survival of patients treated with matched therapies was 5 months (95% CI, 2.9 months to not reached), and the progression-free survival probability at 6 months was 43%(95% CI, 26% to 71%). Lack of locally available clinical trials was the major limitation on clinical actionability of tumor profiling reports. CONCLUSION: The molecular tumor board recommended off-label targeted therapies for a quarter of all patients reviewed. Outcomes were heterogeneous, although 43% of patients receiving genomically matched therapy derived clinical benefit lasting at least 6 months. Until more data become available from precision oncology trials, molecular tumor boards can help guide appropriate use of tumor molecular testing to direct therapy.
Authors: Frederic J Kaye; Alison M Ivey; Walter E Drane; William M Mendenhall; Robert W Allan Journal: J Natl Cancer Inst Date: 2014-12-03 Impact factor: 13.506
Authors: Heather A Parsons; Julia A Beaver; Ashley Cimino-Mathews; Siraj M Ali; Jennifer Axilbund; David Chu; Roisin M Connolly; Rory L Cochran; Sarah Croessmann; Travis A Clark; Christopher D Gocke; Stacie C Jeter; Mark R Kennedy; Josh Lauring; Justin Lee; Doron Lipson; Vincent A Miller; Geoff A Otto; Gary L Rosner; Jeffrey S Ross; Shannon Slater; Philip J Stephens; Dustin A VanDenBerg; Antonio C Wolff; Lauren E Young; Daniel J Zabransky; Zhe Zhang; Jane Zorzi; Vered Stearns; Ben H Park Journal: Clin Cancer Res Date: 2016-08-03 Impact factor: 12.531
Authors: Funda Meric-Bernstam; Amber Johnson; Vijaykumar Holla; Ann Marie Bailey; Lauren Brusco; Ken Chen; Mark Routbort; Keyur P Patel; Jia Zeng; Scott Kopetz; Michael A Davies; Sarina A Piha-Paul; David S Hong; Agda Karina Eterovic; Apostolia M Tsimberidou; Russell Broaddus; Elmer V Bernstam; Kenna R Shaw; John Mendelsohn; Gordon B Mills Journal: J Natl Cancer Inst Date: 2015-04-11 Impact factor: 13.506
Authors: Sai-Hong Ignatius Ou; Ramaswamy Govindan; Keith D Eaton; Gregory A Otterson; Martin E Gutierrez; Alain C Mita; Athanassios Argiris; Nicoletta M Brega; Tiziana Usari; Weiwei Tan; Steffan N Ho; Francisco Robert Journal: J Thorac Oncol Date: 2016-09-30 Impact factor: 15.609
Authors: Maria Schwaederle; Hatim Husain; Paul T Fanta; David E Piccioni; Santosh Kesari; Richard B Schwab; Sandip P Patel; Olivier Harismendy; Megumi Ikeda; Barbara A Parker; Razelle Kurzrock Journal: Clin Cancer Res Date: 2016-05-16 Impact factor: 12.531
Authors: Barbara A Parker; Maria Schwaederlé; Michael D Scur; Sarah G Boles; Teresa Helsten; Rupa Subramanian; Richard B Schwab; Razelle Kurzrock Journal: J Oncol Pract Date: 2015-08-04 Impact factor: 3.840
Authors: Jeffrey S Ross; Kai Wang; Juliann Chmielecki; Laurie Gay; Adrienne Johnson; Jacob Chudnovsky; Roman Yelensky; Doron Lipson; Siraj M Ali; Julia A Elvin; Jo-Anne Vergilio; Steven Roels; Vincent A Miller; Brooke N Nakamura; Adam Gray; Michael K Wong; Philip J Stephens Journal: Int J Cancer Date: 2015-09-08 Impact factor: 7.396
Authors: Lillian L Siu; Mark Lawler; David Haussler; Bartha Maria Knoppers; Jeremy Lewin; Daniel J Vis; Rachel G Liao; Fabrice Andre; Ian Banks; J Carl Barrett; Carlos Caldas; Anamaria Aranha Camargo; Rebecca C Fitzgerald; Mao Mao; John E Mattison; William Pao; William R Sellers; Patrick Sullivan; Bin Tean Teh; Robyn L Ward; Jean Claude ZenKlusen; Charles L Sawyers; Emile E Voest Journal: Nat Med Date: 2016-05-05 Impact factor: 53.440
Authors: Jacob J Chabon; Andrew D Simmons; Alexander F Lovejoy; Mohammad S Esfahani; Aaron M Newman; Henry J Haringsma; David M Kurtz; Henning Stehr; Florian Scherer; Chris A Karlovich; Thomas C Harding; Kathleen A Durkin; Gregory A Otterson; W Thomas Purcell; D Ross Camidge; Jonathan W Goldman; Lecia V Sequist; Zofia Piotrowska; Heather A Wakelee; Joel W Neal; Ash A Alizadeh; Maximilian Diehn Journal: Nat Commun Date: 2016-06-10 Impact factor: 14.919
Authors: Aubrie Eaton; Victor Wong; Deborah Schiff; Eric Anderson; Hilda Ding; Edmund V Capparelli; Deb Determan; Dennis John Kuo Journal: J Pediatr Pharmacol Ther Date: 2022-02-09
Authors: Catherine G Fischer; Aparna Pallavajjala; LiQun Jiang; Valsamo Anagnostou; Jessica Tao; Emily Adams; James R Eshleman; Christopher D Gocke; Ming-Tseh Lin; Elizabeth A Platz; Rena R Xian Journal: Clin Cancer Res Date: 2022-06-01 Impact factor: 13.801
Authors: Florian Borchert; Andreas Mock; Aurelie Tomczak; Jonas Hügel; Samer Alkarkoukly; Alexander Knurr; Anna-Lena Volckmar; Albrecht Stenzinger; Peter Schirmacher; Jürgen Debus; Dirk Jäger; Thomas Longerich; Stefan Fröhling; Roland Eils; Nina Bougatf; Ulrich Sax; Matthieu-P Schapranow Journal: Brief Bioinform Date: 2021-11-05 Impact factor: 11.622
Authors: Kara L Larson; Bin Huang; Heidi L Weiss; Pam Hull; Philip M Westgate; Rachel W Miller; Susanne M Arnold; Jill M Kolesar Journal: JCO Precis Oncol Date: 2021-07-09
Authors: Michelle F Green; Jonathan L Bell; Christopher B Hubbard; Shannon J McCall; Matthew S McKinney; Jinny E Riedel; Carolyn S Menendez; James L Abbruzzese; John H Strickler; Michael B Datto Journal: JCO Precis Oncol Date: 2021-09-16
Authors: Patience Obasaju; Shubin Shahab; Emily Dunn; Daniel S Rhee; LiQun Jiang; Jeffrey S Dome; Alan D Friedman; Pedram Argani; Christine A Pratilas Journal: Cold Spring Harb Mol Case Stud Date: 2020-04-01