Molecular Tumor Board of the University Medical Center Groningen (UMCGMTB): outcome of patients with rare or complex mutational profiles receiving MTB-advised targeted therapy

被引：1

作者：

deJager, V. D. ^{[1
]}

Plomp, P. ^{[2
]}

Paats, M. S. ^{[3
]}

van Helvert, S. ^{[4
]}

ter Elst, A. ^{[1
]}

van den Berg, A. ^{[1
]}

Dubbink, H. J. ^{[5
]}

van Geffen, W. H. ^{[6
]}

Zhang, L. ^{[7
]}

Hendriks, L. E. L. ^{[8
]}

Hiltermann, T. J. N. ^{[9
]}

Hiddinga, B. I. ^{[9
]}

Hijmering-Kappelle, L. B. M. ^{[9
]}

Jalving, M. ^{[10
]}

Kluiver, J. ^{[1
]}

Koopman, B. ^{[1
]}

van Kruchten, M. ^{[10
]}

van der Logt, E. M. J. ^{[1
,11
]}

Piet, B. ^{[12
]}

van Putten, J. ^{[13
]}

Reitsma, B. H. ^{[14
]}

Rutgers, S. R. ^{[15
]}

de Vries, M. ^{[16
]}

Stigt, J. A. ^{[2
]}

Groves, M. R. ^{[7
]}

Timens, W. ^{[1
]}

Willems, S. M. ^{[1
]}

van Kempent, L. C. ^{[1
]}

Schuuring, E. ^{[1
]}

van der Wekken, A. J. ^{[9
]}

机构：

[1] Univ Groningen, Univ Med Ctr Groningen, Dept Pathol & Med Biol, Groningen, Netherlands

[2] Isala Hosp, Dept Nucl Med, Zwolle, Netherlands

[3] Univ Med Ctr Rotterdam, Erasmus MC Canc Inst, Dept Pulm Med, Rotterdam, Netherlands

[4] Radboud Univ Nijmegen Med Ctr, Dept Pathol, Nijmegen, Netherlands

[5] Univ Med Ctr Rotterdam, Erasmus MC Canc Inst, Dept Pathol, Rotterdam, Netherlands

[6] Med Ctr Leeuwarden, Dept Pulm Dis, Leeuwarden, Netherlands

[7] Univ Groningen, Groningen Res Inst Pharm, Struct Biol Drug Design, Groningen, Netherlands

[8] Maastricht Univ Med Ctr, GROW Sch Oncol & Reprod, Dept Pulm Dis, Maastricht, Netherlands

[9] Univ Groningen, Univ Med Ctr Groningen, Dept Pulm Dis & TB, Groningen, Netherlands

[10] Univ Groningen, Univ Med Ctr Groningen, Dept Med Oncol, Groningen, Netherlands

[11] Pathol Friesland, Dept Mol Diag, Leeuwarden, Netherlands

[12] Radboud Univ Nijmegen Med Ctr, Dept Pulm Dis, Nijmegen, Netherlands

[13] Martini Hosp, Dept Pulm Dis, Groningen, Netherlands

[14] Nij Smellinghe, Dept Pulmonol, Drachten, Netherlands

[15] Scheper Hosp, Treant Hosp Grp, Treant Care Grp, Emmen, Netherlands

[16] Tjongerschans, Dept Pulmonol, Heerenveen, Netherlands

来源：

ESMO OPEN | 2024年 / 9卷 / 11期

关键词：

molecular tumor board; targeted therapy; precision oncology; real-world data; clinical decision making; molecular pathology; CLINICAL-PRACTICE GUIDELINE; CELL LUNG-CANCER; OSIMERTINIB; DABRAFENIB; RESISTANCE; DIAGNOSIS; NSCLC;

D O I：

10.1016/j.esmoop.2024.103966

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: Molecular tumor boards (MTBs) are considered beneficial for treatment decision making for patients with cancer with uncommon, rare, or complex mutational profiles. The lack of international MTB guidelines results in significant variation in practices and recommendations. Therefore, periodic follow-up is necessary to assess and govern MTB functioning. The objective of this study was to determine the effectiveness of MTB treatment recommendations for patients with rare and complex mutational profiles as implemented in the MTB of the Patients and methods: A retrospective follow-up study was carried out to determine the clinical outcome of patients with uncommon or rare (combinations of) molecular aberrations for whom targeted therapy was recommended as the next line of treatment by the UMCG-MTB in 2019 and 2020. Results: The UMCG-MTB recommended targeted therapy as the next line of treatment in 132 of 327 patients: 37 in clinical trials, 67 in the on-label setting, and 28 in the off-label setting. For on- and off-label treatment recommendations, congruence of recommended and received treatment was 85% in patients with available followup (67/79). Treatment with on-label therapy resulted in a response rate of 50% (21/42), a median progression-free survival (PFS) of 6.3 months [interquartile range (IQR) 2.9-14.9 months], and median overall survival (OS) of 15.8 months (IQR 6.4-34.2 months). Treatment with off-label therapy resulted in a response rate of 53% (8/15), a median PFS of 5.1 months (IQR 1.9-7.3 months), and a median OS of 17.7 months (IQR 5.1-23.7 months). Conclusion: Treatment with MTB-recommended next-line targeted therapy for patients with often heavily pretreated cancer with rare and complex mutational profiles resulted in positive overall responses in over half of patients. Off-label use of targeted therapies, for which there is sufficient rationale as determined by an MTB, is an effective treatment strategy. This study underlines the relevance of discussing patients with rare and complex mutational profiles in an MTB.

引用

页数：12

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