Department of Medicine III and Comprehensive Cancer Center (CCC Munich LMU), University Hospital, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany.
German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.
J Cancer Res Clin Oncol. 2023 May;149(5):1905-1915. doi: 10.1007/s00432-022-04165-0. Epub 2022 Jul 7.
In 2016, the University of Munich Molecular Tumor Board (MTB) was implemented to initiate a precision oncology program. This review of cases was conducted to assess clinical implications and functionality of the program, to identify current limitations and to inform future directions of these efforts.
Charts, molecular profiles, and tumor board decisions of the first 1000 consecutive cases (01/2016-03/2020) were reviewed. Descriptive statistics were applied to describe relevant findings.
Of the first 1000 patients presented to the MTB; 914 patients received comprehensive genomic profiling. Median age of patients was 56 years and 58% were female. The most prevalent diagnoses were breast (16%) and colorectal cancer (10%). Different types of targeted or genome-wide sequencing assays were used; most of them offered by the local department of pathology. Testing was technically successful in 88%. In 41% of cases, a genomic alteration triggered a therapeutic recommendation. The fraction of patients receiving a tumor board recommendation differed significantly between malignancies ranging from over 50% in breast or biliary tract to less than 30% in pancreatic cancers. Based on a retrospective chart review, 17% of patients with an MTB recommendation received appropriate treatment.
Based on these retrospective analyses, patients with certain malignancies (breast and biliary tract cancer) tend to be more likely to have actionable variants. The low rate of therapeutic implementation (17% of patients receiving a tumor board recommendation) underscores the importance of meticulous follow-up for these patients and ensuring broad access to innovative therapies for patients receiving molecular tumor profiling.
2016 年，慕尼黑大学分子肿瘤委员会（MTB）成立，旨在启动精准肿瘤学计划。本研究回顾了这些病例，旨在评估该计划的临床意义和功能，确定当前的局限性，并为未来的努力提供信息。
回顾了前 1000 例连续病例（2016 年 1 月至 2020 年 3 月）的图表、分子谱和肿瘤委员会的决策。应用描述性统计方法描述相关发现。
在提交给 MTB 的前 1000 名患者中；914 名患者接受了全面的基因组分析。患者的中位年龄为 56 岁，女性占 58%。最常见的诊断是乳腺癌（16%）和结直肠癌（10%）。使用了不同类型的靶向或全基因组测序检测；大多数由当地病理部门提供。技术上检测成功率为 88%。在 41%的病例中，基因组改变引发了治疗建议。在不同的恶性肿瘤中，接受肿瘤委员会建议的患者比例差异显著，从乳腺癌或胆道癌的 50%以上到胰腺癌的不到 30%。基于回顾性图表审查，17%的 MTB 推荐患者接受了适当的治疗。
基于这些回顾性分析，某些恶性肿瘤（乳腺癌和胆道癌）的患者更有可能具有可操作的变异。治疗实施率低（接受肿瘤委员会建议的患者中 17%）强调了对这些患者进行精心随访的重要性，并确保为接受分子肿瘤分析的患者广泛获得创新疗法。
