Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Khalifa Institute for Personalized Cancer Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Nat Rev Clin Oncol. 2023 Dec;20(12):843-863. doi: 10.1038/s41571-023-00824-4. Epub 2023 Oct 16.
Over the past 15 years, rapid progress has been made in developmental therapeutics, especially regarding the use of matched targeted therapies against specific oncogenic molecular alterations across cancer types. Molecular tumour boards (MTBs) are panels of expert physicians, scientists, health-care providers and patient advocates who review and interpret molecular-profiling results for individual patients with cancer and match each patient to available therapies, which can include investigational drugs. Interpretation of the molecular alterations found in each patient is a complicated task that requires an understanding of their contextual functional effects and their correlations with sensitivity or resistance to specific treatments. The criteria for determining the actionability of molecular alterations and selecting matched treatments are constantly evolving. Therefore, MTBs have an increasingly necessary role in optimizing the allocation of biomarker-directed therapies and the implementation of precision oncology. Ultimately, increased MTB availability, accessibility and performance are likely to improve patient care. The challenges faced by MTBs are increasing, owing to the plethora of identifiable molecular alterations and immune markers in tumours of individual patients and their evolving clinical significance as more and more data on patient outcomes and results from clinical trials become available. Beyond next-generation sequencing, broader biomarker analyses can provide useful information. However, greater funding, resources and expertise are needed to ensure the sustainability of MTBs and expand their outreach to underserved populations. Harmonization between practice and policy will be required to optimally implement precision oncology. Herein, we discuss the evolving role of MTBs and current and future considerations for their use in precision oncology.
在过去的 15 年中，在发展治疗学方面取得了迅速进展，尤其是在针对癌症类型中特定致癌分子改变使用匹配的靶向治疗方面。分子肿瘤委员会（MTB）是由专家医生、科学家、医疗保健提供者和患者权益倡导者组成的小组，他们审查和解释癌症患者的分子分析结果，并将每位患者与可用的治疗方法相匹配，其中可能包括试验性药物。解释每位患者中发现的分子改变是一项复杂的任务，需要了解其上下文功能影响及其与对特定治疗的敏感性或耐药性的相关性。确定分子改变可操作性和选择匹配治疗的标准在不断发展。因此，MTB 在优化生物标志物指导治疗的分配和实施精准肿瘤学方面发挥着越来越重要的作用。最终，MTB 的可用性、可及性和性能的提高可能会改善患者的护理。由于个体患者肿瘤中可识别的分子改变和免疫标志物数量繁多，以及随着越来越多的患者结局数据和临床试验结果可用，其临床意义不断演变，MTB 面临的挑战也在增加。除了下一代测序外，更广泛的生物标志物分析也可以提供有用的信息。然而，需要更多的资金、资源和专业知识来确保 MTB 的可持续性，并扩大其对服务不足人群的覆盖范围。需要在实践和政策之间进行协调，以最佳地实施精准肿瘤学。本文讨论了 MTB 不断变化的作用以及在精准肿瘤学中使用 MTB 的当前和未来考虑因素。
