PURPOSE: Precision oncology develops and implements evidence-based personalized therapies that are based on specific genetic targets within each tumor. However, a major challenge that remains is the provision of a standardized, up-to-date, and evidenced-based precision medicine initiative across a geographic region. MATERIALS AND METHODS: We developed a statewide molecular tumor board that integrates academic and community oncology practices. The Precision Medicine Molecular Tumor Board (PMMTB) has three components: a biweekly Web-based teleconference tumor board meeting provided as a free clinical service, an observational research registry, and a monthly journal club to establish and revise evidence-based guidelines for off-label therapies. The PMMTB allows for flexible and rapid implementation of treatment, uniformity in practice, and the ability to track outcomes. RESULTS: We describe the implementation of the PMMTB and its first year of activity. Seventy-seven patient cases were presented, 48 were enrolled in a registry, and 38 had recommendations and clinical follow-up. The 38 subjects had diverse solid tumors (lung, 45%; GI, 21%; breast, 13%; other, 21%). Of these subjects, targeted therapy was recommended for 32 (84%). Clinical trials were identified for 24 subjects (63%), and nontrial targeted medicines for 16 (42%). Nine subjects (28%) received recommended therapy with a response rate of 17% (one of six) and a clinical benefit rate (partial response + stable disease) of 38% (three of eight). Although clinical trials often were identified, patients rarely enrolled. CONCLUSION: The PMMTB provides a model for a regional molecular tumor board with clinical utility. This work highlights the need for outcome registries and improved access to clinical trials to pragmatically implement precision oncology.
PURPOSE: Precision oncology develops and implements evidence-based personalized therapies that are based on specific genetic targets within each tumor. However, a major challenge that remains is the provision of a standardized, up-to-date, and evidenced-based precision medicine initiative across a geographic region. MATERIALS AND METHODS: We developed a statewide molecular tumor board that integrates academic and community oncology practices. The Precision Medicine Molecular Tumor Board (PMMTB) has three components: a biweekly Web-based teleconference tumor board meeting provided as a free clinical service, an observational research registry, and a monthly journal club to establish and revise evidence-based guidelines for off-label therapies. The PMMTB allows for flexible and rapid implementation of treatment, uniformity in practice, and the ability to track outcomes. RESULTS: We describe the implementation of the PMMTB and its first year of activity. Seventy-seven patient cases were presented, 48 were enrolled in a registry, and 38 had recommendations and clinical follow-up. The 38 subjects had diverse solid tumors (lung, 45%; GI, 21%; breast, 13%; other, 21%). Of these subjects, targeted therapy was recommended for 32 (84%). Clinical trials were identified for 24 subjects (63%), and nontrial targeted medicines for 16 (42%). Nine subjects (28%) received recommended therapy with a response rate of 17% (one of six) and a clinical benefit rate (partial response + stable disease) of 38% (three of eight). Although clinical trials often were identified, patients rarely enrolled. CONCLUSION: The PMMTB provides a model for a regional molecular tumor board with clinical utility. This work highlights the need for outcome registries and improved access to clinical trials to pragmatically implement precision oncology.
Authors: Maria Schwaederle; Barbara A Parker; Richard B Schwab; Paul T Fanta; Sarah G Boles; Gregory A Daniels; Lyudmila A Bazhenova; Rupa Subramanian; Alice C Coutinho; Haydee Ojeda-Fournier; Brian Datnow; Nicholas J Webster; Scott M Lippman; Razelle Kurzrock Journal: Oncologist Date: 2014-05-05
Authors: Funda Meric-Bernstam; Lauren Brusco; Kenna Shaw; Chacha Horombe; Scott Kopetz; Michael A Davies; Mark Routbort; Sarina A Piha-Paul; Filip Janku; Naoto Ueno; David Hong; John De Groot; Vinod Ravi; Yisheng Li; Raja Luthra; Keyur Patel; Russell Broaddus; John Mendelsohn; Gordon B Mills Journal: J Clin Oncol Date: 2015-05-26 Impact factor: 44.544
Authors: Apostolia-Maria Tsimberidou; Nancy G Iskander; David S Hong; Jennifer J Wheler; Gerald S Falchook; Siqing Fu; Sarina Piha-Paul; Aung Naing; Filip Janku; Rajyalakshmi Luthra; Yang Ye; Sijin Wen; Donald Berry; Razelle Kurzrock Journal: Clin Cancer Res Date: 2012-09-10 Impact factor: 12.531
Authors: Milan Radovich; Patrick J Kiel; Stacy M Nance; Erin E Niland; Megan E Parsley; Meagan E Ferguson; Guanglong Jiang; Natraj R Ammakkanavar; Lawrence H Einhorn; Liang Cheng; Mehdi Nassiri; Darrell D Davidson; Daniel A Rushing; Patrick J Loehrer; Roberto Pili; Nasser Hanna; J Thomas Callaghan; Todd C Skaar; Paul R Helft; Safi Shahda; Bert H O'Neil; Bryan P Schneider Journal: Oncotarget Date: 2016-08-30
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: Bin Huang; Quan Chen; Derek Allison; Riham El Khouli; Keng Hee Peh; James Mobley; Abigail Anderson; Eric B Durbin; Donald Goodin; John L Villano; Rachel W Miller; Susanne M Arnold; Jill M Kolesar Journal: JCO Precis Oncol Date: 2021-09-29
Authors: Lidia S van Huizen; Pieter U Dijkstra; Sjoukje van der Werf; Kees Ahaus; Jan Ln Roodenburg Journal: BMJ Open Date: 2021-12-09 Impact factor: 2.692
Authors: Rachel W Miller; Megan L Hutchcraft; Heidi L Weiss; Jianrong Wu; Chi Wang; Jinpeng Liu; Rani Jayswal; Mikayla Buchanan; Abigail Anderson; Derek B Allison; Riham H El Khouli; Reema A Patel; John L Villano; Susanne M Arnold; Jill M Kolesar Journal: JCO Precis Oncol Date: 2022-08
Authors: Aline F Fares; Pedro H Martinez; Pedro H Farina; Isaac Bicalho de Souza; Daniel V Araújo; Narayana S Paiva; Ligia F Orlando; Tatiana Elias Colombo; Eldsamira Mascarenhas; Ana Caroline Z Gelatti; Clarissa Baldotto; Mauro Zukin; Luiz Henrique Araujo; Clarissa Mathias; Gustavo Werutsky; Gilberto de Castro; Vladmir C Cordeiro de Lima Journal: JTO Clin Res Rep Date: 2022-08-30
Authors: May T Cho; Sepideh Gholami; Dorina Gui; Sooraj L Tejaswi; Ghaneh Fananapazir; Nadine Abi-Jaoudeh; Zeljka Jutric; Jason B Samarasena; Xiaodong Li; Jennifer B Valerin; Jacob Mercer; Farshid Dayyani Journal: Cancers (Basel) Date: 2022-01-13 Impact factor: 6.639