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Implementation of a molecular tumor board at a regional level to improve access to targeted therapy

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Abstract

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.

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Author information

Author notes

  1. Héloïse Bourien and Alexandra Lespagnol have contributed equally.

  2. Jean Mosser and Julien Edeline have contributed equally to this work.

Authors and Affiliations

  1. Centre Eugene Marquis, Unicancer, Rennes, France

    Héloïse Bourien, Boris Campillo-Gimenez, Thierry Lesimple & Julien Edeline

  2. CHU Pontchaillou, Rennes, France

    Alexandra Lespagnol, Romain Corre, Lise Boussemart, Solène-Florence Kammerer-Jacquet, Florent Denoual, Marie de Tayrac, Marie-Dominique Galibert & Jean Mosser

  3. Pôle Régionale de Cancérologie de Bretagne, Rennes, France

    Ingrid Felten-Vinot, Jean-Philippe Metges & Edouard le Gall

  4. CHU Brest, Brest, France

    Jean-Philippe Metges & Cédric le Marechal

  5. ARPEGO (Accès à La Recherche Précoce Dans Le Grand-Ouest) Network, Rennes, France

    Jean-Philippe Metges, Romain Corre, Thierry Lesimple & Julien Edeline

  6. Université Rennes, CNRS, IGDR, UMR 6290, Rennes, France

    Lise Boussemart, Marie-Dominique Galibert & Jean Mosser

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  1. Héloïse Bourien
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Correspondence to Héloïse Bourien.

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Bourien, H., Lespagnol, A., Campillo-Gimenez, B. et al. Implementation of a molecular tumor board at a regional level to improve access to targeted therapy. Int J Clin Oncol 25, 1234–1241 (2020). https://doi.org/10.1007/s10147-020-01661-6

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  • DOI: https://doi.org/10.1007/s10147-020-01661-6

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