Knepper Todd C, Bell Gillian C, Hicks J Kevin, Padron Eric, Teer Jamie K, Vo Teresa T, Gillis Nancy K, Mason Neil T, McLeod Howard L, Walko Christine M
DeBartolo Family Personalized Medicine Institute, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
Oncologist. 2017 Feb;22(2):144-151. doi: 10.1634/theoncologist.2016-0195. Epub 2017 Feb 8.
The increasing practicality of genomic sequencing technology has led to its incorporation into routine clinical practice. Successful identification and targeting of driver genomic alterations that provide proliferative and survival advantages to tumor cells have led to approval and ongoing development of several targeted cancer therapies. Within many major cancer centers, molecular tumor boards are constituted to shepherd precision medicine into clinical practice.
In July 2014, the Clinical Genomics Action Committee (CGAC) was established as the molecular tumor board companion to the Personalized Medicine Clinical Service (PMCS) at Moffitt Cancer Center in Tampa, Florida. The processes and outcomes of the program were assessed in order to help others move into the practice of precision medicine.
Through the establishment and initial 1,400 patients of the PMCS and its associated molecular tumor board at a major cancer center, five practical lessons of broad applicability have been learned: transdisciplinary engagement, the use of the molecular report as an aid to clinical management, clinical actionability, getting therapeutic options to patients, and financial considerations. Value to patients includes access to cutting-edge practice merged with individualized preferences in treatment and care.
Genomic-driven cancer medicine is increasingly becoming a part of routine clinical practice. For successful implementation of precision cancer medicine, strategically organized molecular tumor boards are critical to provide objective evidence-based translation of observed molecular alterations into patient-centered clinical action. Molecular tumor board implementation models along with clinical and economic outcomes will define future treatment standards. 2017;22:144-151 It is clear that the increasing practicality of genetic tumor sequencing technology has led to its incorporation as part of routine clinical practice. Subsequently, many cancer centers are seeking to develop a personalized medicine services and/or molecular tumor board to shepherd precision medicine into clinical practice. This article discusses the key lessons learned through the establishment and development of a molecular tumor board and personalized medicine clinical service. This article highlights practical issues and can serve as an important guide to other centers as they conceive and develop their own personalized medicine services and molecular tumor boards.
基因组测序技术实用性的不断提高已使其被纳入常规临床实践。成功识别并靶向那些赋予肿瘤细胞增殖和生存优势的驱动基因组改变，已促成了几种靶向癌症疗法的获批及持续研发。在许多大型癌症中心，都组建了分子肿瘤委员会，以将精准医学引入临床实践。
2014年7月，临床基因组学行动委员会（CGAC）成立，作为佛罗里达州坦帕市莫菲特癌症中心个性化医学临床服务（PMCS）的分子肿瘤委员会伙伴。对该项目的流程和结果进行了评估，以帮助其他机构开展精准医学实践。
通过在一家大型癌症中心建立PMCS及其相关分子肿瘤委员会并纳入最初的1400名患者，我们学到了五条具有广泛适用性的实用经验：跨学科参与、利用分子报告辅助临床管理、临床可操作性、为患者提供治疗选择以及财务考量。对患者的价值包括获得前沿实践，并结合个性化的治疗和护理偏好。
基因组驱动的癌症医学正日益成为常规临床实践的一部分。为了成功实施精准癌症医学，战略组织的分子肿瘤委员会对于将观察到的分子改变以客观、基于证据的方式转化为以患者为中心的临床行动至关重要。分子肿瘤委员会的实施模式以及临床和经济结果将定义未来的治疗标准。2017年；22卷：144 - 151页 显然，基因肿瘤测序技术实用性的不断提高已使其成为常规临床实践的一部分。随后，许多癌症中心都在寻求开发个性化医学服务和/或分子肿瘤委员会，以将精准医学引入临床实践。本文讨论了通过建立和发展分子肿瘤委员会及个性化医学临床服务所学到的关键经验。本文突出了实际问题，可作为其他中心构思和发展自己的个性化医学服务及分子肿瘤委员会的重要指南。
