Molecular Tumor Boards: Evolving Role in Precision Oncology and Biomarker Interpretation
This review examines the increasingly essential role of molecular tumor boards (MTBs) in interpreting NGS-based molecular profiling results and matching patients with appropriate targeted therapies. The authors discuss the growing complexity of actionability criteria, the need to integrate biomarkers beyond sequencing (immune markers, protein expression), and the challenges of harmonizing MTB practice with reimbursement and regulatory policy. Expanding MTB availability and standardizing their processes is positioned as critical for equitable implementation of precision oncology.
The original study
Molecular tumour boards - current and future considerations for precision oncology.
- Authors
- Tsimberidou AM, Kahle M, Vo HH, Baysal MA, Johnson A, Meric-Bernstam F
- Journal
- Nature reviews. Clinical oncology
- Type
- Journal Article, Review, Research Support, Non-U.S. Gov't, Research Support, N.I.H., Extramural
- PMID
- 37845306
Original abstract
Over the past 15 years, rapid progress has been made in developmental therapeutics, especially regarding the use of matched targeted therapies against specific oncogenic molecular alterations across cancer types. Molecular tumour boards (MTBs) are panels of expert physicians, scientists, health-care providers and patient advocates who review and interpret molecular-profiling results for individual patients with cancer and match each patient to available therapies, which can include investigational drugs. Interpretation of the molecular alterations found in each patient is a complicated task that requires an understanding of their contextual functional effects and their correlations with sensitivity or resistance to specific treatments. The criteria for determining the actionability of molecular alterations and selecting matched treatments are constantly evolving. Therefore, MTBs have an increasingly necessary role in optimizing the allocation of biomarker-directed therapies and the implementation of precision oncology. Ultimately, increased MTB availability, accessibility and performance are likely to improve patient care. The challenges faced by MTBs are increasing, owing to the plethora of identifiable molecular alterations and immune markers in tumours of individual patients and their evolving clinical significance as more and more data on patient outcomes and results from clinical trials become available. Beyond next-generation sequencing, broader biomarker analyses can provide useful information. However, greater funding, resources and expertise are needed to ensure the sustainability of MTBs and expand their outreach to underserved populations. Harmonization between practice and policy will be required to optimally implement precision oncology. Herein, we discuss the evolving role of MTBs and current and future considerations for their use in precision oncology.