Bart Koopman1, Harry J M Groen2, Marjolijn J L Ligtenberg3,4, Katrien Grünberg3, Kim Monkhorst5, Adrianus J de Langen6, Mirjam C Boelens5, Marthe S Paats7, Jan H von der Thüsen8, Winand N M Dinjens8, Nienke Solleveld9, Tom van Wezel5,9, Hans Gelderblom10, Lizza E Hendriks11, Ernst-Jan M Speel12, Tom E Theunissen12, Leonie I Kroeze3, Niven Mehra13, Berber Piet14, Anthonie J van der Wekken2, Arja Ter Elst1, Wim Timens1, Stefan M Willems1,15, Ruud W J Meijers15, Wendy W J de Leng15, Anne S R van Lindert16, Teodora Radonic17, Sayed M S Hashemi18, Daniëlle A M Heideman17, Ed Schuuring1, Léon C van Kempen1. 1. Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 2. Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 3. Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands. 4. Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands. 5. Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands. 6. Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands. 7. Department of Pulmonary Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands. 8. Department of Pathology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands. 9. Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands. 10. Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands. 11. Department of Pulmonary Diseases, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands. 12. Department of Pathology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands. 13. Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands. 14. Department of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, The Netherlands. 15. Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands. 16. Department of Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands. 17. Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. 18. Department of Pulmonary Diseases, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Abstract
BACKGROUND: Molecular tumor boards (MTBs) provide rational, genomics-driven, patient-tailored treatment recommendations. Worldwide, MTBs differ in terms of scope, composition, methods, and recommendations. This study aimed to assess differences in methods and agreement in treatment recommendations among MTBs from tertiary cancer referral centers in The Netherlands. MATERIALS AND METHODS: MTBs from all tertiary cancer referral centers in The Netherlands were invited to participate. A survey assessing scope, value, logistics, composition, decision-making method, reporting, and registration of the MTBs was completed through on-site interviews with members from each MTB. Targeted therapy recommendations were compared using 10 anonymized cases. Participating MTBs were asked to provide a treatment recommendation in accordance with their own methods. Agreement was based on which molecular alteration(s) was considered actionable with the next line of targeted therapy. RESULTS: Interviews with 24 members of eight MTBs revealed that all participating MTBs focused on rare or complex mutational cancer profiles, operated independently of cancer type-specific multidisciplinary teams, and consisted of at least (thoracic and/or medical) oncologists, pathologists, and clinical scientists in molecular pathology. Differences were the types of cancer discussed and the methods used to achieve a recommendation. Nevertheless, agreement among MTB recommendations, based on identified actionable molecular alteration(s), was high for the 10 evaluated cases (86%). CONCLUSION: MTBs associated with tertiary cancer referral centers in The Netherlands are similar in setup and reach a high agreement in recommendations for rare or complex mutational cancer profiles. We propose a "Dutch MTB model" for an optimal, collaborative, and nationally aligned MTB workflow. IMPLICATIONS FOR PRACTICE: Interpretation of genomic analyses for optimal choice of target therapy for patients with cancer is becoming increasingly complex. A molecular tumor board (MTB) supports oncologists in rationalizing therapy options. However, there is no consensus on the most optimal setup for an MTB, which can affect the quality of recommendations. This study reveals that the eight MTBs associated with tertiary cancer referral centers in The Netherlands are similar in setup and reach a high agreement in recommendations for rare or complex mutational profiles. The Dutch MTB model is based on a collaborative and nationally aligned workflow with interinstitutional collaboration and data sharing.
BACKGROUND: Molecular tumor boards (MTBs) provide rational, genomics-driven, patient-tailored treatment recommendations. Worldwide, MTBs differ in terms of scope, composition, methods, and recommendations. This study aimed to assess differences in methods and agreement in treatment recommendations among MTBs from tertiary cancer referral centers in The Netherlands. MATERIALS AND METHODS: MTBs from all tertiary cancer referral centers in The Netherlands were invited to participate. A survey assessing scope, value, logistics, composition, decision-making method, reporting, and registration of the MTBs was completed through on-site interviews with members from each MTB. Targeted therapy recommendations were compared using 10 anonymized cases. Participating MTBs were asked to provide a treatment recommendation in accordance with their own methods. Agreement was based on which molecular alteration(s) was considered actionable with the next line of targeted therapy. RESULTS: Interviews with 24 members of eight MTBs revealed that all participating MTBs focused on rare or complex mutational cancer profiles, operated independently of cancer type-specific multidisciplinary teams, and consisted of at least (thoracic and/or medical) oncologists, pathologists, and clinical scientists in molecular pathology. Differences were the types of cancer discussed and the methods used to achieve a recommendation. Nevertheless, agreement among MTB recommendations, based on identified actionable molecular alteration(s), was high for the 10 evaluated cases (86%). CONCLUSION: MTBs associated with tertiary cancer referral centers in The Netherlands are similar in setup and reach a high agreement in recommendations for rare or complex mutational cancer profiles. We propose a "Dutch MTB model" for an optimal, collaborative, and nationally aligned MTB workflow. IMPLICATIONS FOR PRACTICE: Interpretation of genomic analyses for optimal choice of target therapy for patients with cancer is becoming increasingly complex. A molecular tumor board (MTB) supports oncologists in rationalizing therapy options. However, there is no consensus on the most optimal setup for an MTB, which can affect the quality of recommendations. This study reveals that the eight MTBs associated with tertiary cancer referral centers in The Netherlands are similar in setup and reach a high agreement in recommendations for rare or complex mutational profiles. The Dutch MTB model is based on a collaborative and nationally aligned workflow with interinstitutional collaboration and data sharing.
Authors: Peter Horak; Jonas Leichsenring; Simon Kreuzfeldt; Daniel Kazdal; Veronica Teleanu; Volker Endris; Anna-Lena Volckmar; Marcus Renner; Martina Kirchner; Christoph E Heilig; Olaf Neumann; Peter Schirmacher; Stefan Fröhling; Albrecht Stenzinger Journal: Pathologe Date: 2021-05-03 Impact factor: 1.011
Authors: Neha M Jain; Lauren Schmalz; Christopher Cann; Adara Holland; Travis Osterman; Katie Lang; Georgia L Wiesner; Tuya Pal; Christine Lovly; Thomas Stricker; Christine Micheel; Justin M Balko; Douglas B Johnson; Ben Ho Park; Wade Iams Journal: Oncologist Date: 2021-09-08
Authors: Gennaro Ciliberto; Marco Canfora; Irene Terrenato; Chiara Agnoletto; Francesco Agustoni; Loredana Amoroso; Gustavo Baldassarre; Giuseppe Curigliano; Angelo Delmonte; Antonella De Luca; Michelangelo Fiorentino; Vanesa Gregorc; Toni Ibrahim; Chiara Lazzari; Angela Mastronuzzi; Paolo Pronzato; Armando Santoro; Giovanni Scambia; Stefania Tommasi; Andrea Vingiani; Patrizio Giacomini; Ruggero De Maria Journal: J Exp Clin Cancer Res Date: 2022-10-17