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Several tumor types, including adenoid cystic carcinoma and squamous cell carcinomas of the head and neck, showed some evidence of tumor size reductions in all or most patients, although the sample sizes were small for each group (Fig 3). Consistent with the tumor agnostic NCI-MATCH trial platform and the Arm I-specific exclusion of breast and squamous cell lung cancer, patients with 37 distinct tumor histologies were enrolled. Patients with prior cancers who were disease-free for 5 years, or adequately treated basal or squamous cell skin cancer, in situ cervical cancer, or adequately treated other stage I or II cancer in complete remission were permitted. Most AEs were grade 1 and 2, although 19 of 66 (29%) patients experienced grade 3 AEs, one patient (2%) experienced grade 4 hyperglycemia, and two patients had grade 5 AEs (sudden death and neoplasm). [Extracted from the article]

Purpose: Tumor genomic profiling for personalized oncology therapy is being widely applied in clinical practice even as it is being evaluated more formally in clinical trials. Given the complexities of genomic data and its application to clinical use, molecular tumor boards with diverse expertise can provide guidance to oncologists and patients seeking to implement personalized genetically targeted therapy in practice. Methods: A multidisciplinary molecular tumor board reviewed tumor molecular profiling reports from consecutive referrals at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins over a 3-year period. The tumor board weighed evidence for actionability of genomic alterations identified by molecular profiling and provided recommendations including US Food and Drug Administration–approved drug therapy, clinical trials of matched targeted therapy, off-label use of such therapy, and additional tumor or germline genetic testing. Results: One hundred fifty-five patients were reviewed. Actionable genomic alterations were identified in 132 patients (85%). Off-label therapies were recommended in 37 patients (24%). Eleven patients were treated off-label, and 13 patients were enrolled onto clinical trials of matched targeted therapies. Median progression-free survival of patients treated with matched therapies was 5 months (95% CI, 2.9 months to not reached), and the progression-free survival probability at 6 months was 43% (95% CI, 26% to 71%). Lack of locally available clinical trials was the major limitation on clinical actionability of tumor profiling reports. Conclusion: The molecular tumor board recommended off-label targeted therapies for a quarter of all patients reviewed. Outcomes were heterogeneous, although 43% of patients receiving genomically matched therapy derived clinical benefit lasting at least 6 months. Until more data become available from precision oncology trials, molecular tumor boards can help guide appropriate use of tumor molecular testing to direct therapy. [ABSTRACT FROM AUTHOR]