Molecular screening programs in different countries: what we learned and perspectives.

PURPOSE OF REVIEW: Precision medicine arised as a new paradigm in oncology in which molecular profiling aims at guiding therapy in oncology. The implementation of precision medicine necessitates setting up molecular tumor boards (MTBs) that coordinate the workflow of tumor samples to efficiently seek for actionable molecular alterations. We review here the main precision medicine initiatives that involve MTBs and decipher challenges that still need to be overcome along with future perspectives for a broader implementation of precision medicine in routine patient care. RECENT
FINDINGS: MTBs have been implemented in multiple countries. They identify actionable molecular alteration in up to 50% of patients. However, around 10-20% receive matched therapy and less than 6% of patients experience an objective response. The challenges that need to be overcome for a successful implementation of precision medicine include an earlier molecular profiling of patients during their disease course, the use of liquid biopsies that allow sequential analyses, along with more exhaustive gene panels and extended access to drugs.
SUMMARY: Molecular screening programs allow to successfully guiding patients to individualized therapy in a minority of patients, and few patients actually benefit from these programs.