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分子肿瘤委员会对癌症患者临床管理的影响。

Impact of Molecular Tumor Board on the Clinical Management of Patients With Cancer.

机构信息

Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India.

Homi Bhabha National Institute, Mumbai, India.

出版信息

JCO Glob Oncol. 2022 Jul;8:e2200030. doi: 10.1200/GO.22.00030.

Abstract

PURPOSE

Multidisciplinary molecular tumor boards (MTBs) help in interpreting complex genomic data generated by molecular tumor profiling and improve patients' access to targeted therapies. The purpose of this study was to assess the impact of our institution's MTB on the clinical management of patients with cancer.

METHODS

This study was conducted at a tertiary cancer center in India. Cases to be discussed in the MTB were identified by molecular pathologists, scientists, or oncologists. On the basis of the clinical data and molecular test reports, a course of clinical management was recommended and made available to the treating oncologist. We determined the proportion of patients who were recommended a change in the clinical management. We also assessed compliance of the treating oncologists with MTB recommendations.

RESULTS

There were 339 discussions for 328 unique patients. The median age of the cohort was 54 years (range 17-87), and the majority of the patients were men (65.1%). Of 339 cases, 133 (39.2%) were recommended continuation of ongoing therapy while the remaining 206 (60.7%) were recommended a change in clinical management. Compliance with MTB recommendations for a change in clinical management was 58.5% (79 of 138 evaluable cases). Compliance and implementation for MTB's recommendation to start a new therapy in 104 evaluable cases were 60.5% and 44.2%, respectively. A total of 248 biopsies had at least one actionable mutation. A total of 646 mutations were identified in the cohort, with being the most frequently altered gene.

CONCLUSION

MTBs help in interpreting results of molecular tests, understanding the significance of molecular abnormalities, and assessing the benefits of available targeted therapies and clinical trials in the management of patients with targetable genetic alterations.

摘要

目的

多学科分子肿瘤委员会(MTB)有助于解释分子肿瘤分析产生的复杂基因组数据,并改善患者获得靶向治疗的机会。本研究旨在评估我们机构的 MTB 对癌症患者临床管理的影响。

方法

本研究在印度的一家三级癌症中心进行。分子病理学家、科学家或肿瘤学家确定要在 MTB 中讨论的病例。根据临床数据和分子检测报告,推荐了临床管理方案,并提供给主治肿瘤医生。我们确定了建议改变临床管理的患者比例。我们还评估了主治肿瘤医生对 MTB 建议的遵从性。

结果

为 328 名独特患者进行了 339 次讨论。队列的中位年龄为 54 岁(范围 17-87),大多数患者为男性(65.1%)。在 339 例病例中,133 例(39.2%)建议继续进行现有治疗,而其余 206 例(60.7%)建议改变临床管理。MTB 建议改变临床管理的遵从率为 58.5%(79/138 例可评估病例)。MTB 建议开始新治疗的 104 例可评估病例的遵从率和实施率分别为 60.5%和 44.2%。共有 248 份活检至少有一个可操作的突变。在该队列中鉴定出 646 个突变,最常改变的基因是 。

结论

MTB 有助于解释分子检测结果,理解分子异常的意义,并评估在管理具有靶向遗传改变的患者时,可用靶向治疗和临床试验的获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d343/9296182/798e94b441c9/go-8-e2200030-g002.jpg

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