Implementation and Clinical Utility of an Integrated Academic-Community Regional Molecular Tumor Board.

Purpose: Precision oncology develops and implements evidence-based personalized therapies that are based on specific genetic targets within each tumor. However, a major challenge that remains is the provision of a standardized, up-to-date, and evidenced-based precision medicine initiative across a geographic region.
Materials and Methods: We developed a statewide molecular tumor board that integrates academic and community oncology practices. The Precision Medicine Molecular Tumor Board (PMMTB) has three components: a biweekly Web-based teleconference tumor board meeting provided as a free clinical service, an observational research registry, and a monthly journal club to establish and revise evidence-based guidelines for off-label therapies. The PMMTB allows for flexible and rapid implementation of treatment, uniformity in practice, and the ability to track outcomes.
Results: We describe the implementation of the PMMTB and its first year of activity. Seventy-seven patient cases were presented, 48 were enrolled in a registry, and 38 had recommendations and clinical follow-up. The 38 subjects had diverse solid tumors (lung, 45%; GI, 21%; breast, 13%; other, 21%). Of these subjects, targeted therapy was recommended for 32 (84%). Clinical trials were identified for 24 subjects (63%), and nontrial targeted medicines for 16 (42%). Nine subjects (28%) received recommended therapy with a response rate of 17% (one of six) and a clinical benefit rate (partial response + stable disease) of 38% (three of eight). Although clinical trials often were identified, patients rarely enrolled.
Conclusion: The PMMTB provides a model for a regional molecular tumor board with clinical utility. This work highlights the need for outcome registries and improved access to clinical trials to pragmatically implement precision oncology.
Competing Interests: Implementation and Clinical Utility of an Integrated Academic-Community Regional Molecular Tumor BoardThe following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or po.ascopubs.org/site/ifc.Mark E. BurkardResearch Funding: Pfizer, AbbVie, Genentech Consulting or Advisory Role: Pointcare GenomicsDustin A. DemingNo relationship to discloseBenjamin M. ParsonsHonoraria: Amgen, CelgeneParaic A. KennyNo relationship to discloseMarissa R. SchuhNo relationship to discloseTiciana LealConsulting or Advisory Role: Genentech, AriadNataliya UbohaNo relationship to discloseJoshua M. LangStock and Other Ownership Interests: Salus DiscoveryMichael A. ThompsonNo relationship to discloseRuth WarrenNo relationship to discloseJordan BaumanNo relationship to discloseMary S. MablyNo relationship to discloseJennifer LaffinNo relationship to discloseCatherine R. PaschalNo relationship to discloseAngela M. LagerNo relationship to discloseKristy LeeNo relationship to discloseKristina A. MatkowskyjNo relationship to discloseDarya G. BuehlerNo relationship to discloseWilliam M. RehrauerNo relationship to discloseJill KolesarNo relationship to disclose
(© 2017 by American Society of Clinical Oncology.)