Abstract
There is a growing need for systems that efficiently support the work of medical teams at the precision-oncology point of care. Here, we present the implementation of the Molecular Tumor Board Portal (MTBP), an academic clinical decision support system developed under the umbrella of Cancer Core Europe that creates a unified legal, scientific and technological platform to share and harness next-generation sequencing data. Automating the interpretation and reporting of sequencing results decrease the need for time-consuming manual procedures that are prone to errors. The adoption of an expert-agreed process to systematically link tumor molecular profiles with clinical actions promotes consistent decision-making and structured data capture across the connected centers. The use of information-rich patient reports with interactive content facilitates collaborative discussion of complex cases during virtual molecular tumor board meetings. Overall, streamlined digital systems like the MTBP are crucial to better address the challenges brought by precision oncology and accelerate the use of emerging biomarkers.
Highlights
Next-generation sequencing (NGS) assays are a key component of the modern oncology workflow
Note that different types of assertions can be mapped to the context-agnostic notion of a variant being functionally relevant; for example, a given BRCA1 mutation can be considered as a putative loss-of-function event when it is known to predispose to early breast/ovarian cancer, as well as when it is associated with clinical efficacy of poly-ADP ribose polymerase inhibitors
The Molecular Tumor Board Portal (MTBP) queries a number of expert knowledge bases that continuously gather results of clinical, experimental and population genetic studies[4–10] according to the standard procedures defined for each of their respective scopes, and assertions compatible with the functional relevance of the observed variant are matched as appropriate
Summary
Next-generation sequencing (NGS) assays are a key component of the modern oncology workflow. In the absence of on-label treatment options, patients must be matched with the specific portfolio of investigational therapies and clinical trials available in each hospital (or hospital network), which are subject to continuous changes. Failure to address these issues or the inability to perform them in a clinically acceptable time frame can impair the outcome of individual patients and precision cancer medicine initiatives. Seamless communication among clinical investigators is essential to leverage the collective expertise of the community in this era of rapidly changing precision-oncology landscape To our knowledge, this is an unprecedented effort for codeveloping new anticancer therapies and biomarkers under a harmonized infrastructure in Europe. We describe our approach and discuss the results of using the MTBP in a consecutive cohort of 500 advanced solid tumors evaluated from January 2019 to January 2021 in the context of the Basket of Baskets (NCT03767075) study, an ongoing CCE multibasket phase 2 clinical trial matching molecular biomarkers with immunotherapies and targeted drugs
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