Molecular Tumor Boards (MTBs) converge state-of-the-art next-generation sequencing (NGS) methods with the expertise of an interdisciplinary team consisting of clinicians, pathologists, human geneticists, and molecular biologists to provide molecularly informed guidance in clinical decision making to the treating physician. In the present study, we particularly focused on elucidating the factors impacting on the clinical translation of MTB recommendations, utilizing data generated from gene panel mediated comprehensive genomic profiling (CGP) of 554 patients at the MTB of the Comprehensive Cancer Center Erlangen, Germany, during the years 2016 to 2020. A subgroup analysis of cases with available follow-up data (n= 332) revealed 139 cases with a molecularly informed MTB recommendation, which was successfully implemented in the clinic in 44 (31.7%) of these cases. Here, the molecularly matched treatment was applied in 45.4% (n= 20/44) of cases for ≥6 months and in 25% (n= 11/44) of cases for 12 months or longer (median time to treatment failure, TTF: 5 months, min: 1 month, max: 38 months, ongoing at data cut-off). In general, recommendations were preferentially implemented in the clinic when of high (i.e., tier 1) clinical evidence level. In particular, this was the case for MTB recommendations suggesting the application of PARP, PIK3CA, and IDH1/2 inhibitors. The main reason for non-compliance to the MTB recommendation was either the application of non-matched treatment modalities (n= 30)/stable disease (n= 7), or deteriorating patient condition (n= 22)/death of patient (n= 9). In summary, this study provides an insight into the factors affecting the clinical implementation of molecularly informed MTB recommendations, and careful considerations of these factors may guide future processes of clinical decision making.
分子肿瘤委员会（MTBs）整合了最先进的下一代测序（NGS）技术与由临床医生、病理学家、人类遗传学家和分子生物学家组成的跨学科团队的专业知识，为临床医生提供基于分子信息的诊疗决策指导。本研究特别聚焦于阐明影响MTB建议临床转化的因素，利用德国埃尔朗根综合癌症中心MTB在2016年至2020年间对554名患者通过基因组合介导的全面基因组测序（CGP）产生的数据进行分析。对具有可用随访数据的病例亚组（n=332）的分析显示，其中139例获得了基于分子信息的MTB建议，其中44例（31.7%）在临床中成功实施。在这些实施病例中，分子匹配治疗在45.4%（n=20/44）的病例中应用时间≥6个月，在25%（n=11/44）的病例中应用时间达到12个月或更长（治疗失败中位时间TTF：5个月，最短：1个月，最长：38个月，截至数据截止时仍在进行）。总体而言，当临床证据等级较高（即1级）时，建议在临床中更易被采纳。特别是针对建议应用PARP、PIK3CA和IDH1/2抑制剂的MTB推荐。未遵循MTB建议的主要原因包括应用非匹配治疗方案（n=30）/疾病稳定（n=7），或患者病情恶化（n=22）/患者死亡（n=9）。总之，本研究深入探讨了影响基于分子信息的MTB建议临床实施的因素，对这些因素的审慎考量可为未来临床决策过程提供指导。
肿瘤(癌症)患者之家