“Optimal use of molecular biomarkers means learning a new language,” says MG Kris from Memorial Sloan Kettering (MSK) Center, New York. Molecular tumor boards are essential to achieve that goal.
Why this matters
For patients to profit from personalized therapies, the advances of sequencing technologies need to be translated into clinical practice.
Summary of numerous publications and own experience at Memorial Sloan Kettering (MSK) Center, New York.
- Precision medicine for lung cancers is here, but the gap is widening between the people planning care and those delivering it. The growing amount of information needs to be mined and curated.
- In 733 specimens from patients, a large proportion had actionable drivers of mutations with a twofold difference in median survival between them. That kind of information affects the care of patients, and it also means longer survival with targeted therapy.
- Technology is available to routinely test tumor cells for hundreds of cancer-related genes (468 at MSK) BUT interpretation of results for a GP is practically impossible.
- In the US, that information must not be exchanged electronically, so it is done through faxes and photocopies thereof, and addendums to pathology reports, which largely increases the likelihood of errors. There is also concern about the completeness of data.
- Order to this chaos can be brought by a molecular tumor board that should ideally consist of: a medical oncologist, patient navigator, anatomic and molecular pathologist, pulmonologist, interventional radiologist, thoracic surgeon, and a coordinator.
Speaker and consultancy honoraria from AstraZeneca, Ariad, Array, Clovis, Daiichi-Sankyo, Pfizer, Roche/Genentech, Regeneron, Threshold Pharmaceuticals.