Background

With the development of precision oncology, Molecular Tumor Boards (MTB) are developing in many institutions. However, the implementation of MTB in routine clinical practice has still not been thoroughly studied.

Material and methods

Since the first drugs approved for targeted therapies, patient tumor samples were centralized to genomic testing platforms. In our institution, all tumor samples have been analyzed since 2014 by Next Generation Sequencing (NGS). In 2015, we established a regional MTB to discuss patient cases with 1 or more alterations identified by NGS, in genes different from those related to drug approval. We conducted a retrospective comparative analysis to study whether our MTB increased the prescriptions of Molecular Targeted Therapies (MTT) and the inclusions of patients in clinical trials with MTT, in comparison with patients with available NGS data but no MTB discussion.

Results

In 2014, 86 patients had UGA, but the results were not available to clinicians and not discussed in MTB. During the years 2015 and 2016, 113 patients with an UGA (unreferenced genomic alteration) were discussed in MTB. No patients with an UGA were included in 2014 in a clinical trial, versus 2 (2%) in 2015–2016. 13 patients with an UGA (12%) were treated in 2015–2016 with a MTT whereas in 2014, no patient (p = 0.001).

Conclusions

In this retrospective analysis, we showed that the association of large-scale genomic testing and MTB was feasible, and could increase the prescription of MTT. However, in routine clinical practice, the majority of patients with UGA still do not have access to MTT.

中文翻译：

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在区域一级实施分子肿瘤委员会以改善获得靶向治疗的机会。

背景

随着精密肿瘤学的发展，许多机构都在开发分子肿瘤板（MTB）。但是，尚未在常规临床实践中对MTB的实施进行深入研究。

材料与方法

自从首批药物被批准用于靶向治疗以来，患者肿瘤样本就集中到了基因组测试平台上。自2014年以来，在我们机构中，所有肿瘤样品均已通过下一代测序（NGS）进行了分析。2015年，我们建立了一个区域性MTB，以讨论NGS鉴定出的一种或多种具有与药物批准相关的不同基因的改变的患者病例。我们进行了回顾性比较分析，以研究我们的MTB是否与分子靶向疗法（MTT）的处方增加以及与MTT进行临床试验的患者的纳入，与具有可用NGS数据但未讨论MTB的患者进行比较。

结果

2014年，有86例患者患有UGA，但临床医生无法获得结果，MTB对此也未进行讨论。在2015年和2016年间，MTB讨论了113例UGA（未参考基因组改变）患者。2014年，没有UGA患者被纳入临床试验，而2015-2016年为2（2％）。在2015–2016年间，有13例UGA患者（占12％）接受了MTT治疗，而在2014年，没有患者（p  = 0.001）。

结论

在这项回顾性分析中，我们表明大规模基因组测试与MTB的关联是可行的，并且可以增加MTT的处方。但是，在常规临床实践中，大多数UGA患者仍无法使用MTT。