Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Oncologist. 2021 Nov;26(11):e1962-e1970. doi: 10.1002/onco.13936. Epub 2021 Sep 8.
Over the past few years, tumor next-generation sequencing (NGS) panels have evolved in complexity and have changed from selected gene panels with a handful of genes to larger panels with hundreds of genes, sometimes in combination with paired germline filtering and/or testing. With this move toward increasingly large NGS panels, we have rapidly outgrown the available literature supporting the utility of treatments targeting many reported gene alterations, making it challenging for oncology providers to interpret NGS results and make a therapy recommendation for their patients.
To support the oncologists at Vanderbilt-Ingram Cancer Center (VICC) in interpreting NGS reports for patient care, we initiated two molecular tumor boards (MTBs)-a VICC-specific institutional board for our patients and a global community MTB open to the larger oncology patient population. Core attendees include oncologists, hematologist, molecular pathologists, cancer geneticists, and cancer genetic counselors. Recommendations generated from MTB were documented in a formal report that was uploaded to our electronic health record system.
As of December 2020, we have discussed over 170 patient cases from 77 unique oncology providers from VICC and its affiliate sites, and a total of 58 international patient cases by 25 unique providers from six different countries across the globe. Breast cancer and lung cancer were the most presented diagnoses.
In this article, we share our learning from the MTB experience and document best practices at our institution. We aim to lay a framework that allows other institutions to recreate MTBs.
With the rapid pace of molecularly driven therapies entering the oncology care spectrum, there is a need to create resources that support timely and accurate interpretation of next-generation sequencing reports to guide treatment decision for patients. Molecular tumor boards (MTB) have been created as a response to this knowledge gap. This report shares implementation strategies and best practices from the Vanderbilt experience of creating an institutional MTB and a virtual global MTB for the larger oncology community. This report describe a reproducible framework that can be adopted to initiate MTBs at other institutions.
在过去的几年中，肿瘤下一代测序（NGS）面板的复杂性不断发展，已经从少数基因的精选基因面板转变为具有数百个基因的更大面板，有时还与配对的种系过滤和/或测试相结合。随着向越来越大的 NGS 面板的发展，我们迅速超出了支持针对许多报道的基因改变的治疗的可用文献，这使得肿瘤学提供者难以解释 NGS 结果并为其患者推荐治疗。
为了支持范德比尔特 - 英格拉姆癌症中心（VICC）的肿瘤学家解释 NGS 报告以进行患者护理，我们启动了两个分子肿瘤委员会（MTB） - 一个是针对我们患者的 VICC 特定机构委员会，另一个是向更大的肿瘤患者群体开放的全球社区 MTB。核心参与者包括肿瘤学家、血液学家、分子病理学家、癌症遗传学家和癌症遗传咨询师。从 MTB 生成的建议记录在一份正式报告中，该报告上传到我们的电子健康记录系统。
截至 2020 年 12 月，我们已经讨论了来自 VICC 及其附属站点的 77 位独特肿瘤提供者的 170 多个患者病例，以及来自全球六个不同国家的 25 位独特提供者的 58 个国际患者病例。乳腺癌和肺癌是最常见的诊断。
在本文中，我们分享了从 MTB 经验中获得的学习，并记录了我们机构的最佳实践。我们旨在为其他机构提供一个可以重新创建 MTB 的框架。
随着分子驱动疗法迅速进入肿瘤学护理范围，需要创建资源以支持及时准确地解释下一代测序报告，为患者的治疗决策提供指导。分子肿瘤委员会（MTB）就是为了应对这一知识差距而创建的。本报告介绍了创建机构 MTB 和面向更大肿瘤学社区的虚拟全球 MTB 的范德比尔特实施策略和最佳实践。本报告描述了一个可复制的框架，可以在其他机构采用来启动 MTB。
