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Support of a molecular tumour board by an evidence-based decision management system for precision oncology.

Author information

Affiliations

  • 1. Charité Comprehensive Cancer Center, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
      Authors
    • Lamping M 1
    • Leyvraz S 1
    • Burock S 1
    (3 authors)
  • 2. Department of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany; IRI Life Sciences, Humboldt-Universität zu Berlin, Philippstraße 13, 10115, Berlin, Germany.
      Authors
    • Benary M 2
    (1 author)
  • 3. Core Unit Bioinformatics, Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, 10178, Berlin, Germany.
      Authors
    • Messerschmidt C 3
    • Blanc E 3
    • Beule D 3
    (3 authors)
  • 4. Alacris Theranostics GmbH, Max Planck Straße 3, 12489, Berlin, Germany.
      Authors
    • Kessler T 4
    • Schütte M 4
    (2 authors)
  • 5. Department of Pathology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
      Authors
    • Lenze D 5
    • Jöhrens K 5
    • Sers C 5
    • Klauschen F 5
    (4 authors)
    • Show all (11)

ORCIDs linked to this article

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European Journal of Cancer (Oxford, England : 1990), 23 Jan 2020, 127:41-51
https://doi.org/10.1016/j.ejca.2019.12.017 PMID: 31982633 

Abstract 

Background

Reliable and reproducible interpretation of molecular aberrations constitutes a bottleneck of precision medicine. Evidence-based decision management systems may improve rational therapy recommendations. To cope with an increasing amount of complex molecular data in the clinical care of patients with cancer, we established a workflow for the interpretation of molecular analyses.

Methods

A specialized physician screened results from molecular analyses for potential biomarkers, irrespective of the diagnostic modality. Best available evidence was retrieved and categorized through establishment of an in-house database and interrogation of publicly available databases. Annotated biomarkers were ranked using predefined evidence levels and subsequently discussed at a molecular tumour board (MTB), which generated treatment recommendations. Subsequent translation into patient treatment and clinical outcomes were followed up.

Results

One hundred patients were discussed in the MTB between January 2016 and May 2017. Molecular data were obtained for 70 of 100 patients (50 whole exome/RNA sequencing, 18 panel sequencing, 2 immunohistochemistry (IHC)/microsatellite instability analysis). The MTB generated a median of two treatment recommendations each for 63 patients. Thirty-nine patients were treated: 6 partial responses and 12 stable diseases were achieved as best responses. Genetic counselling for germline events was recommended for seven patients.

Conclusion

The development of an evidence-based workflow allowed for the clinical interpretation of complex molecular data and facilitated the translation of personalized treatment strategies into routine clinical care. The high number of treatment recommendations in patients with comprehensive genomic data and promising responses in patients treated with combination therapy warrant larger clinical studies.

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Read article at publisher's site: https://doi.org/10.1016/j.ejca.2019.12.017

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Funding 

Funders who supported this work.

Bundesministerium für Bildung und Forschung

    Deutschen Konsortium für Translationale Krebsforschung