Abstract

Abstract Background: Molecular tumor boards (MTB) are a key component of most precision oncology programs, designed to provide a structured multidisciplinary approach to evaluating cancer patients (pts) for therapy (Tx), clinical trial (CT) enrollment, and genetic counseling (GC) services. Two health systems separately instituted MTB in 2017, and through a bio-informatics platform have been tracking the impact of these on pt care. We describe the collective experience in tracking MTB impact. Methods: This is a retrospective cohort study of pts reviewed for the first time by MTB between September 1, 2017 and September 30, 2020 at either of the two health systems (HS). Follow up data were obtained by a certified tumor registrar at a median time of 109 days after presentation. Demographics and clinical characteristics of MTB pts were obtained. Pts were identified for whom Tx or CTs were recommended and subsequently administered after MTB review, along with pts for whom GC was recommended and subsequently had genetic testing performed. Results: 351 pts were evaluated. Pt demographics included: median age of 65 years; 61% female; 83% White, 13% Black, 3% Asian, with 2% of Hispanic/Latino ethnicity. The most common primary sites observed were lung (75 pts; 21%), breast (44 pts; 13%) and central nervous system (26 pts, 7%). 334 pts (95%) had data regarding Tx and CT recommendations. 124 pts (37%) received a Tx recommendation and 36 (29%) of these received Tx. 73 pts (22%) received a CT recommendation and 4 (6%) of these pts were enrolled on CTs. 340 pts (97%) had data regarding GC recommendations. 94 pts (28%) received a GC referral and 28 (30%) of these received GC. 25 (89%) of these received a molecular test for germline cancer risk, and 10 (40%) of these had a risk mutation identified in one of the following: ATM (4), BRCA2 (2), BARD1 (1), CHEK2 (1), RAD51C (1), and RET (1). Conclusions: MTB was successful in matching pts to Tx and CT, and in providing appropriate referrals to GC and identifying germline risk mutations. The bio-informatics platform provided a uniform format and structure to collate and analyze data between programs. These parameters will serve as a baseline to monitor future MTB impact and trends as these precision oncology programs continue to grow. The relatively low percentage of patients of color whose cases were reviewed in this MTB analysis merits further understanding. Citation Format: Igor I. Rybkin, Michael A. Thompson, Frank M. Wolf, Kristen Collins, Louisa Laidlaw, Tom Mikkelsen, Jennifer Godden, Mary Walters, James L. Weese, Ronda Broome, Joe Burkhart, Veronica Jones, Chenan Zhang, Thomas D. Brown, Anna Berry. Molecular tumor board impact at two large health systems [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2021 Oct 7-10. Philadelphia (PA): AACR; Mol Cancer Ther 2021;20(12 Suppl):Abstract nr P159.

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