Cancers (Mar 2021)

Transitioning the Molecular Tumor Board from Proof of Concept to Clinical Routine: A German Single-Center Analysis

  • Rouven Hoefflin,
  • Adriana Lazarou,
  • Maria Elena Hess,
  • Meike Reiser,
  • Julius Wehrle,
  • Patrick Metzger,
  • Anna Verena Frey,
  • Heiko Becker,
  • Konrad Aumann,
  • Kai Berner,
  • Martin Boeker,
  • Nico Buettner,
  • Christine Dierks,
  • Jesus Duque-Afonso,
  • Michel Eisenblaetter,
  • Thalia Erbes,
  • Ralph Fritsch,
  • Isabell Xiang Ge,
  • Anna-Lena Geißler,
  • Markus Grabbert,
  • Steffen Heeg,
  • Dieter Henrik Heiland,
  • Simone Hettmer,
  • Gian Kayser,
  • Alexander Keller,
  • Anita Kleiber,
  • Alexandra Kutilina,
  • Leman Mehmed,
  • Frank Meiss,
  • Philipp Poxleitner,
  • Justyna Rawluk,
  • Juri Ruf,
  • Henning Schäfer,
  • Florian Scherer,
  • Khalid Shoumariyeh,
  • Andreas Tzschach,
  • Christoph Peters,
  • Tilman Brummer,
  • Martin Werner,
  • Justus Duyster,
  • Silke Lassmann,
  • Cornelius Miething,
  • Melanie Boerries,
  • Anna L. Illert,
  • Nikolas von Bubnoff

DOI
https://doi.org/10.3390/cancers13051151
Journal volume & issue
Vol. 13, no. 5
p. 1151

Abstract

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Molecular precision oncology faces two major challenges: first, to identify relevant and actionable molecular variants in a rapidly changing field and second, to provide access to a broad patient population. Here, we report a four-year experience of the Molecular Tumor Board (MTB) of the Comprehensive Cancer Center Freiburg (Germany) including workflows and process optimizations. This retrospective single-center study includes data on 488 patients enrolled in the MTB from February 2015 through December 2018. Recommendations include individual molecular diagnostics, molecular stratified therapies, assessment of treatment adherence and patient outcomes including overall survival. The majority of MTB patients presented with stage IV oncologic malignancies (90.6%) and underwent an average of 2.1 previous lines of therapy. Individual diagnostic recommendations were given to 487 patients (99.8%). A treatment recommendation was given in 264 of all cases (54.1%) which included a molecularly matched treatment in 212 patients (43.4%). The 264 treatment recommendations were implemented in 76 patients (28.8%). Stable disease was observed in 19 patients (25.0%), 17 had partial response (22.4%) and five showed a complete remission (6.6%). An objective response was achieved in 28.9% of cases with implemented recommendations and for 4.5% of the total population (22 of 488 patients). By optimizing the MTB workflow, case-discussions per session increased significantly while treatment adherence and outcome remained stable over time. Our data demonstrate the feasibility and effectiveness of molecular-guided personalized therapy for cancer patients in a clinical routine setting showing a low but robust and durable disease control rate over time.

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