Implementation of a molecular tumor board at a regional level to improve access to targeted therapy

Heloise Bourien (1) , Alexandra Lespagnol (2) , Boris Campillo-Gimenez (1) , Ingrid Felten-Vinot (2) , Jean-Philippe Metges (3, 2) , Romain Corre (2) , Thierry Lesimple (1) , Cedric Le Marechal (3) , Lise Boussemart (2, 4) , Solène-Florence Kammerer-Jacquet (5, 2) , Edouard Le Gall (2) , Florent Denoual (2) , Marie de Tayrac (2) , Marie-Dominique Galibert (4, 2) , Jean Mosser (2, 4) , Julien Edeline (1)

1 CRLCC - Centre Eugène Marquis
2 CHU Pontchaillou [Rennes]
3 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
4 IGDR - Institut de Génétique et Développement de Rennes
5 Service de Pathologie [Rennes] = Pathology [Rennes]

Background With the development of precision oncology, Molecular Tumor Boards (MTB) are developing in many institutions. However, the implementation of MTB in routine clinical practice has still not been thoroughly studied. Material and methods Since the first drugs approved for targeted therapies, patient tumor samples were centralized to genomic testing platforms. In our institution, all tumor samples have been analyzed since 2014 by Next Generation Sequencing (NGS). In 2015, we established a regional MTB to discuss patient cases with 1 or more alterations identified by NGS, in genes different from those related to drug approval. We conducted a retrospective comparative analysis to study whether our MTB increased the prescriptions of Molecular Targeted Therapies (MTT) and the inclusions of patients in clinical trials with MTT, in comparison with patients with available NGS data but no MTB discussion. Results In 2014, 86 patients had UGA, but the results were not available to clinicians and not discussed in MTB. During the years 2015 and 2016, 113 patients with an UGA (unreferenced genomic alteration) were discussed in MTB. No patients with an UGA were included in 2014 in a clinical trial, versus 2 (2%) in 2015-2016. 13 patients with an UGA (12%) were treated in 2015-2016 with a MTT whereas in 2014, no patient (p = 0.001). Conclusions In this retrospective analysis, we showed that the association of large-scale genomic testing and MTB was feasible, and could increase the prescription of MTT. However, in routine clinical practice, the majority of patients with UGA still do not have access to MTT.

Keywords: Molecular tumor board; Molecular targeted therapy; Next generation sequencing

Domains: Life Sciences [q-bio]; Cancer; Life Sciences [q-bio]; Biochemistry, Molecular Biology; Genomics [q-bio.GN]

Heloise Bourien, Alexandra Lespagnol, Boris Campillo-Gimenez, Ingrid Felten-Vinot, Jean-Philippe Metges, et al.. Implementation of a molecular tumor board at a regional level to improve access to targeted therapy. International Journal of Clinical Oncology, 2020, 25 (7), pp.1234-1241. ⟨10.1007/s10147-020-01661-6⟩. ⟨hal-02565097⟩