scholarly journals Molecular tumor board (MTB): Development of clinical pathways for precision medicine. Experiences of center for breast cancer at national cancer center, Korea

2018 ◽  
Vol 29 ◽  
pp. ix18
Author(s):  
I.H. Park ◽  
C. Park ◽  
W. Jang ◽  
H. Yang ◽  
K. An ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Precision Medicine ◽  
Clinical Pathways ◽  
Tumor Board ◽  
Cancer Center ◽  
Molecular Tumor Board

scholarly journals Breast Cancer Experience of the Molecular Tumor Board at the University of California, San Diego Moores Cancer Center

2015 ◽  
Vol 11 (6) ◽  
pp. 442-449 ◽  
Author(s):  
Barbara A. Parker ◽  
Maria Schwaederlé ◽  
Michael D. Scur ◽  
Sarah G. Boles ◽  
Teresa Helsten ◽  
...  
Keyword(s):  
Breast Cancer ◽  
University Of California ◽  
Tumor Board ◽  
Cancer Center ◽  
Genomic Testing ◽  
Tumor Boards ◽  
Heavily Pretreated ◽  
Molecular Tumor Board ◽  
Cancer Experience ◽  
The University

Multidisciplinary molecular tumor boards may help optimize the management of patients with advanced, heavily pretreated breast cancer who have undergone genomic testing.

Yale Cancer Center Precision Medicine Tumor Board: one tumour, multiple targets

2018 ◽  
Vol 19 (12) ◽  
pp. 1567-1568 ◽  
Author(s):  
Tyler Stewart ◽  
Karin Finberg ◽  
Zenta Walther ◽  
Jeffrey L Sklar ◽  
Navid Hafez ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Tumor Board ◽  
Cancer Center ◽  
Multiple Targets

The Johns Hopkins Molecular Tumor Board Precision Oncology elective for Medical Oncology fellows.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11035-11035
Author(s):  
Kristen Marrone ◽  
Jessica Tao ◽  
Jenna VanLiere Canzoniero ◽  
Paola Ghanem ◽  
Emily Nizialek ◽  
...  
Keyword(s):  
Decision Making ◽  
Precision Medicine ◽  
Clinical Decision Making ◽  
Cancer Genomics ◽  
Medical Oncology ◽  
Clinical Decision ◽  
Tumor Board ◽  
Precision Oncology ◽  
Adaptive Expertise ◽  
Molecular Tumor Board

11035 Background: The accelerated impact of next generation sequencing (NGS) in clinical decision making requires the integration of cancer genomics and precision oncology focused training into medical oncology education. The Johns Hopkins Molecular Tumor Board (JH MTB) is a multi-disciplinary effort focused on integration of NGS findings with critical evidence interpretation to generate personalized recommendations tailored to the genetic footprint of individual patients. Methods: The JH MTB and the Medical Oncology Fellowship Program have developed a 3-month precision oncology elective for fellows in their research years. Commencing fall of 2020, the goals of this elective are to enhance the understanding of NGS platforms and findings, advance the interpretation and characterization of molecular assay outputs by use of mutation annotators and knowledgebases and ultimately master the art of matching NGS findings with available therapies. Fellow integration into the MTB focuses on mentored case-based learning in mutation characterization and ranking by levels of evidence for actionability, with culmination in form of verbal presentations and written summary reports of final MTB recommendations. A mixed methods questionnaire was administered to evaluate progress since elective initiation. Results: Three learners who have participated as of February 2021 were included. Of the two who had completed the MTB elective, each have presented at least 10 cases, with at least 1 scholarly publication planned. All indicated strong agreement that MTB elective had increased their comfort with interpreting clinical NGS reports as well as the use of knowledgebases and variant annotators. Exposure to experts in the field of molecular precision oncology, identification of resources necessary to interpret clinical NGS reports, development of ability to critically assess various NGS platforms, and gained familiarity with computational analyses relevant to clinical decision making were noted as strengths of the MTB elective. Areas of improvement included ongoing initiatives that involve streamlining variant annotation and transcription of information for written reports. Conclusions: A longitudinal elective in the JHU MTB has been found to be preliminarily effective in promoting knowledge mastery and creating academic opportunities related to the clinical application of precision medicine. Future directions will include leveraging of the MTB infrastructure for research projects, learner integration into computational laboratory meetings, and expansion of the MTB curriculum to include different levels of learners from multiple medical education programs. Continued elective participation will be key to understanding how best to facilitate adaptive expertise in assigning clinical relevance to genomic findings, ultimately improving precision medicine delivery in patient care and trial development.

Yale Cancer Center Precision Medicine Tumor Board: new technology, new drugs, and the value of repeat testing

2020 ◽  
Vol 21 (3) ◽  
pp. 343-344
Author(s):  
Navid Hafez ◽  
Zenta Walther ◽  
Joseph P Eder ◽  
Jeffrey L Sklar ◽  
Scott N Gettinger ◽  
...  
Keyword(s):  
Precision Medicine ◽  
New Technology ◽  
New Drugs ◽  
Tumor Board ◽  
Cancer Center ◽  
Repeat Testing

Quality of care improvement in breast and lung cancer.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 252-252
Author(s):  
Douglas D. Letson ◽  
Johnathan M. Lancaster ◽  
Alberto Chiappori ◽  
John W. Peabody ◽  
Lisa DeMaria ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Clinical Decision Making ◽  
Clinical Performance ◽  
Clinical Pathways ◽  
Clinical Care ◽  
Simulated Patients ◽  
Cancer Center ◽  
Serial Measurement

252 Background: Despite the growing call for use of guidelines in cancer care, adherence to clinical pathways and clinical care transformation is a challenge. Moffitt Cancer Center (MCC) has addressed this challenge, in multiple service lines, using its clinical pathways and serial measurement in a broad-based initiative to improve quality of clinical care. Methods: Moffitt launched an initiative focused on quality and improvements in care using Clinical Performance and Value (CPV) vignettes to measure multiple aspects of quality including: clinical decision-making, pathway adherence and appropriate utilization of tests/procedures. The CPVs—simulated patients cared for by providers on-line—are based upon the Moffitt Clinical Pathways. CPVs are given serially to benchmark, motivate providers, and provide confidential individual feedback. Data have been collected every 4 months since mid-2013. We report on three rounds in breast cancer and two rounds in lung cancer. Results: A total of 18 providers at MCC completed the breast cancer CPVs and 19 providers at MCC completed the lung cancer CPVs. Overall scores improved significantly and pathway adherence improved significantly for staging work-up and chemotherapy between rounds 1 and 3 for breast cancer (Table). Conclusions: Adherence to Moffitt Clinical Pathways for breast and lung cancer, using serial measurement and feedback with CPVs, improved across multiple providers and two diseases. This may have potential to transform practice. [Table: see text]

scholarly journals Individualized Molecular Profiling for Allocation to Clinical Trials Singapore Study—An Asian Tertiary Cancer Center Experience

2021 ◽  
pp. 859-875
Author(s):  
Amanda O. L. Seet ◽  
Aaron C. Tan ◽  
Tira J. Tan ◽  
Matthew C. H. Ng ◽  
David W. M. Tai ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Tumor Tissue ◽  
Molecular Profiling ◽  
Tumor Board ◽  
Cancer Center ◽  
Precision Oncology ◽  
Molecular Tumor Board ◽  
Tumor Types ◽  
Tertiary Cancer Center

PURPOSE Precision oncology has transformed the management of advanced cancers through implementation of advanced molecular profiling technologies to identify increasingly defined subsets of patients and match them to appropriate therapy. We report outcomes of a prospective molecular profiling study in a high-volume Asian tertiary cancer center. PATIENTS AND METHODS Patients with advanced cancer were enrolled onto a prospective protocol for genomic profiling, the Individualized Molecular Profiling for Allocation to Clinical Trials Singapore study, at the National Cancer Center Singapore. Primary objective was to identify molecular biomarkers in patient's tumors for allocation to clinical trials. The study commenced in February 2012 and is ongoing, with the results of all patients who underwent multiplex next-generation sequencing (NGS) testing until December 2018 presented here. The results were discussed at a molecular tumor board where recommendations for allocation to biomarker-directed trials or targeted therapies were made. RESULTS One thousand fifteen patients were enrolled with a median age of 58 years (range 20-83 years). Most common tumor types were lung adenocarcinoma (26%), colorectal cancer (15%), and breast cancer (12%). A total of 1,064 NGS assays were performed, on fresh tumor tissue for 369 (35%) and archival tumor tissue for 687 (65%) assays. TP53 (39%) alterations were most common, followed by EGFR (21%), KRAS (14%), and PIK3CA (10%). Of 405 NGS assays with potentially actionable alterations, 111 (27%) were allocated to a clinical trial after molecular tumor board and 20 (4.9%) were enrolled on a molecularly matched clinical trial. Gene fusions were detected in 23 of 311 (7%) patients tested, including rare fusions in new tumor types and known fusions in rare tumors. CONCLUSION Individualized Molecular Profiling for Allocation to Clinical Trials Singapore demonstrates the feasibility of a prospective broad molecular profiling program in an Asian tertiary cancer center, with the ability to develop and adapt to a dynamic landscape of precision oncology.

scholarly journals Enhancing Cancer care of rural dwellers through telehealth and engagement (ENCORE): protocol to evaluate effectiveness of a multi-level telehealth-based intervention to improve rural cancer care delivery

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tuya Pal ◽  
Pamela C. Hull ◽  
Tatsuki Koyama ◽  
Phillip Lammers ◽  
Denise Martinez ◽  
...  
Keyword(s):  
Rural Communities ◽  
Cancer Care ◽  
Care Delivery ◽  
Tumor Board ◽  
Cancer Center ◽  
Dissemination And Implementation ◽  
Link Type ◽  
Multi Level ◽  
Molecular Tumor Board ◽  
Facilitators And Barriers

Abstract Background Despite lower cancer incidence rates, cancer mortality is higher among rural compared to urban dwellers. Patient, provider, and institutional level factors contribute to these disparities. The overarching objective of this study is to leverage the multidisciplinary, multispecialty oncology team from an academic cancer center in order to provide comprehensive cancer care at both the patient and provider levels in rural healthcare centers. Our specific aims are to: 1) evaluate the clinical effectiveness of a multi-level telehealth-based intervention consisting of provider access to molecular tumor board expertise along with patient access to a supportive care intervention to improve cancer care delivery; and 2) identify the facilitators and barriers to future larger scale dissemination and implementation of the multi-level intervention. Methods Coordinated by a National Cancer Institute-designated comprehensive cancer center, this study will include providers and patients across several clinics in two large healthcare systems serving rural communities. Using a telehealth-based molecular tumor board, sequencing results are reviewed, predictive and prognostic markers are discussed, and treatment plans are formulated between expert oncologists and rural providers. Simultaneously, the rural patients will be randomized to receive an evidence-based 6-week self-management supportive care program, Cancer Thriving and Surviving, versus an education attention control. Primary outcomes will be provider uptake of the molecular tumor board recommendation and patient treatment adherence. A mixed methods approach guided by the Consolidated Framework for Implementation Research that combines qualitative key informant interviews and quantitative surveys will be collected from both the patient and provider in order to identify facilitators and barriers to implementing the multi-level intervention. Discussion The proposed study will leverage information technology-enabled, team-based care delivery models in order to deliver comprehensive, coordinated, and high-quality cancer care to rural and/or underserved populations. Simultaneous attention to institutional, provider, and patient level barriers to quality care will afford the opportunity for us to broadly share oncology expertise and develop dissemination and implementation strategies that will enhance the cancer care delivered to patients residing within underserved rural communities. Trial registration Clinicaltrials.gov, NCT04758338. Registered 17 February 2021 – Retrospectively registered, http://www.clinicaltrials.gov/

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