Multicenter Comparison of Molecular Tumor Boards in The Netherlands: Definition, Composition, Methods, and Targeted Therapy Recommendations

The oncologist

article

Bart Koopman¹  Winand N.M. Dinjens²  Nienke Solleveld³  Tom van Wezel⁴  Hans Gelderblom⁵  Lizza E. Hendriks⁶  Ernst-Jan M. Speel⁷  Tom E. Theunissen⁷  Leonie I. Kroeze⁸  Niven Mehra⁹  Berber Piet^1,10  Harry J.M. Groen^1,11  Anthonie J. van der Wekken^1,11  Arja ter Elst¹  Wim Timens¹  Stefan M. Willems¹  Ruud W.J. Meijers^1,12  Wendy W.J. de Leng^1,12  Anne S.R. van Lindert^1,13  Teodora Radonic^1,14  Sayed M.S. Hashemi^1,15  Daniëlle A.M. Heideman^1,14  Marjolijn J.L. Ligtenberg⁸  Ed Schuuring¹  Léon C. van Kempen¹  Katrien Grünberg⁸  Kim Monkhorst⁴  Adrianus J. de Langen^1,17  Mirjam C. Boelens⁴  Marthe S. Paats^1,18  Jan H. von der Thüsen² 

[1] Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen;Department of Pathology, Erasmus Medical Center, University Medical Center Rotterdam;Department of Pathology, Leiden University Medical Center;Department of Pathology, Netherlands Cancer Institute;Department of Medical Oncology, Leiden University Medical Center;Department of Pulmonary Diseases, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center;Department of Pathology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center;Department of Pathology, Radboud University Medical Center;Department of Medical Oncology, Radboud University Medical Center;Department of Pulmonary Diseases, Radboud University Medical Center;Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen;Department of Pathology, University Medical Center Utrecht;Department of Pulmonology, University Medical Center Utrecht;Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam;Department of Pulmonary Diseases, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam;Department of Human Genetics, Radboud University Medical Center;Department of Thoracic Oncology, Netherlands Cancer Institute;Department of Pulmonary Medicine, Erasmus Medical Center, University Medical Center Rotterdam

关键词: Molecular tumor board;    Rare mutations;    Molecular diagnostics;    Decision making;    Multidisciplinary;   

DOI  :  10.1002/onco.13580

学科分类：地质学

来源: AlphaMed Press Incorporated

【 摘 要 】

Background Molecular tumor boards (MTBs) provide rational, genomics-driven, patient-tailored treatment recommendations. Worldwide, MTBs differ in terms of scope, composition, methods, and recommendations. This study aimed to assess differences in methods and agreement in treatment recommendations among MTBs from tertiary cancer referral centers in The Netherlands. Materials and Methods MTBs from all tertiary cancer referral centers in The Netherlands were invited to participate. A survey assessing scope, value, logistics, composition, decision-making method, reporting, and registration of the MTBs was completed through on-site interviews with members from each MTB. Targeted therapy recommendations were compared using 10 anonymized cases. Participating MTBs were asked to provide a treatment recommendation in accordance with their own methods. Agreement was based on which molecular alteration(s) was considered actionable with the next line of targeted therapy. Results Interviews with 24 members of eight MTBs revealed that all participating MTBs focused on rare or complex mutational cancer profiles, operated independently of cancer type–specific multidisciplinary teams, and consisted of at least (thoracic and/or medical) oncologists, pathologists, and clinical scientists in molecular pathology. Differences were the types of cancer discussed and the methods used to achieve a recommendation. Nevertheless, agreement among MTB recommendations, based on identified actionable molecular alteration(s), was high for the 10 evaluated cases (86%). Conclusion MTBs associated with tertiary cancer referral centers in The Netherlands are similar in setup and reach a high agreement in recommendations for rare or complex mutational cancer profiles. We propose a “Dutch MTB model” for an optimal, collaborative, and nationally aligned MTB workflow. Implications for Practice Interpretation of genomic analyses for optimal choice of target therapy for patients with cancer is becoming increasingly complex. A molecular tumor board (MTB) supports oncologists in rationalizing therapy options. However, there is no consensus on the most optimal setup for an MTB, which can affect the quality of recommendations. This study reveals that the eight MTBs associated with tertiary cancer referral centers in The Netherlands are similar in setup and reach a high agreement in recommendations for rare or complex mutational profiles. The Dutch MTB model is based on a collaborative and nationally aligned workflow with interinstitutional collaboration and data sharing.

【 授权许可】

CC BY|CC BY-NC