Molecular Tumor Board

Molecular Tumour Board

What is a MTB?

Molecular Tumour Boards (MTBs) are a specific type of multi-disciplinary tumour board meeting in which anonymized patient cases are discussed based on the patient’s clinical information and genetic sequencing reports.

What is genetic sequencing and what role does it have to play in cancer care

Next-generation sequencing (NGS) is a type of genetic test that is used to study the DNA sequences of cancer cells. A DNA profile of the tumour cells is created which describes mutations or variations found in the genes of cancer cells. This helps us to understand the pathology of the disease. NGS testing generates a lot of data about mutations and genetic variations found within the DNA of cancer cells. As a result of NGS testing the area of cancer genetics is growing rapidly and oncologists are faced with the challenge of keeping up to date with the interpretation and clinical significance of these test results. 

NGS testing is becoming increasingly utilised in clinical practice in Ireland and MTBs are being used globally to provide a forum for doctors to discuss their patient’s cancer genomic findings. The Irish MTB was established in November 2020 as a cross institutional, educational and virtual multi-disciplinary meeting to help oncologists interpret and discuss NGS test results. A panel of international and national genetic, oncology and pathology experts, highly experienced in cancer genetic profiling review oncology patient NGS findings. At the MTB the implications of the findings and potential targeted therapies that may be available for treatment are discussed. In this way the MTB acts a clinical decision support system for oncologists, which result in improved quality of care. 

The discussion of a patient’s case at an MTB is a step forward towards personalised patient care and the MTB provides the treating oncologist with a valuable resource to self-educate, collaborate, and communicate with other healthcare providers working in multidisciplinary medical specialities

Dearbhaile Collins

MTB Clinical Lead

Dearbhaile Collins is the clinical lead for the MTB programme. She is a medical oncologist working in Cork University Hospital with speciality interest in lung cancer and gynecological malignancies. She has both a PhD in translational oncology and MA in Medical Ethics and Law. She is Co-Chair of the Cancer Trials Ireland Gynecology DSSG.

Ambitions for the Irish MTB

Cancer Trials Ireland aims to grow the MTB programme nationally so it becomes an integral part of healthcare for Irish cancer patients. By fostering collaboration on cancer treatment decisions among Irish doctors with support of national and international experts the MTB is supporting the transition towards precision oncology and personalised healthcare. 

Cancer Trials Ireland plans to develop the MTB as a valuable educational resource by creating an online platform to include training material on key concepts and educational cases. The development of a registry for patient data will provide beneficial reference material for oncologists.

History of the Irish MTB

The Irish MTB program was co-designed with Roche and local Irish doctors in 2019 and a pilot MTB programme was initiated in November 2020. Cancer Trials Ireland as the leading cancer trials organisation were onboarded to the programme in 2021 and since July 2022 have taken over the full operations of the national Molecular Tumour Board meetings.

Meet the MTB expert panel

From November 2020 to June 2022, the educational MTB in Ireland has created the following footprint

18

MTBs conducted

36

Patient cases discussed

195

Cumulative participants

16

Participating institutions

2

Conference submissions (ASCO 2022 and ESMO 2022)

The treating HCPs will use a patient case template to share anonymized patient information prior to the MTB sessions

Anonymized patient information is shared in a structured way so that experts can prepare the patient case and HCPs can have an informed discussion during a MTB session.

Ensure key questions are submitted to the experts to allow for proper preparation prior to the MTB session.

Structure of a Patient Case Template to be submitted to mtb@cancertrials.ie

Our vision is to change the way cancer patients in Ireland are treated building on a Molecular Tumour Board (MTB)

1

2020

Piloting the MTB

Pilot a cross-institutional MTB with international experts as an educational service to support HCPs to better understand, interpret, and action multi-gene sequencing reports.

Driven by Roche

2

2021

Evolving the MTB

Hand over operations of the MTB to Cancer Trials Ireland as an ecosystem partner and start to collect and use real world data for patients discussed on MTBs to shape the Irish Health Care System.

Driven by Roche & Cancer Trials Ireland

3

2022

Maintaining the MTB

Fully hand-over the MTB to Cancer Trials Ireland while jointly creating on an ongoing basis meaningful insights based on the collected patient data.

Driven by Cancer Trials Ireland (independent from Roche)

Some of the high-level publications on impact on MTBs

Real-world data from a molecular tumor board demonstrates improved outcomes with a precision N-of-One strategy.

Kato, Shumei, et al., Nature communications 11.1 (2020): 1-9.

Multidisciplinary molecular
tumour board: a tool to improve clinical practice and selection accrual for clinical trials in patients with cancer.

Rolfo, Christian, et al. ESMO open 3.5 (2018): e000398.

Molecular Tumor Board Review and Improved Overall Survival in Non–Small-Cell Lung Cancer.

Huang, Bin, et al., JCO Precision Oncology 5 (2021): 1530-1539.

Transitioning the molecular tumor board from proof of concept to clinical routine: a German single-center analysis.

Hoefflin, Rouven, et al. Cancers 13.5 (2021): 1151.

Framework for Implementing and Tracking a Molecular Tumor Board at a National Cancer Institute–Designated Comprehensive Cancer Center.

Jain, Neha M., et al. The Oncologist (2021).

Molecular tumor board: the University of California San Diego Moores cancer center experience.

Schwaederle, Maria, et al.  The oncologist 19.6 (2014): 631.

Implementation of a
molecular tumor board: the impact on treatment decisions for 35 patients evaluated at Dartmouth-Hitchcock Medical Center.

Tafe, Laura J., et al., The oncologist 20.9 (2015): 1011.

Multicenter
comparison of molecular
tumor boards in The Netherlands: Definition, composition, methods, and targeted therapy recommendations.

Koopman, Bart, et al. , The Oncologist 26.8 (2021): e1347-e1358.