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 tests generate 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 as a pilot project by Roche in November 2020. It is a cross institutional, educational, 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 as a clinical decision support system for oncologists, which results in improved quality of care.
The discussion of a patient’s case at the MTB is a step forward towards personalised patient care and provides the treating oncologist with a valuable resource to self-educate, collaborate, and communicate with other healthcare providers working in multidisciplinary medical specialties
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 gynaecological malignancies. She has both a PhD in translational oncology and a MA in Medical Ethics and Law. She is Co-Chair of the Cancer Trials Ireland Gynaecology DSSG.
“I am honoured to chair the MTB which will help support personalised cancer care in Ireland. It is a tremendously valuable initiative which will have direct patient benefits in addition to educational and research advantages”.
Next Steps for the Irish MTB
Cancer Trials Ireland aims to embed the MTB programme into the 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 driving 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.
The ultimate goal is to connect the Irish MTB with other international MTBs and contribute to an international collection of cancer NGS data, their interpretation and any available treatment option.
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 national leading cancer trials organisation got involved in the programme in 2021 and took over the operations of the national MTB in July 2022. Implementation of the National Molecular Tumour Board Programme has been facilitated through a collaborative agreement between Roche Products (Ireland) Limited and Cancer Trials Ireland.
Meet the MTB expert panel
Terri McVeigh, MB BAO BCh (Hons), PGCert. (Med. Gen.), PGDip. (Med. Sci.), MSc. (Clin. Ed.), PhD, MRCP, MRCS
- Dr Terri McVeigh is a consultant clinical geneticist in the Royal Marsden NHS Foundation Trust, specializing in cancer genetics
- Her interests include Cancer Predisposition in Children, Adolescents and Adults (syndromic and non-syndromic), and application of genomic testing to direct cancer treatment
- Dr McVeigh also has a specialist interest in Clinical Education, and has developed educational material for patients and health care professionals
- She was awarded a PhD from National University of Ireland, Galway for her work investigating the translational applications of genomic profiling in breast cancer
- She holds a Certificate in Medical Genetics, Postgraduate Diploma in Medical Science, and Masters in Clinical Education
- Dr McVeigh undertook undergraduate medical training, core surgical training and Higher Specialist Training in Clinical Genetics in Ireland
Professional Experience (selected)
- Consultant Clinical Geneticist , The Royal Marsden NHS Foundation Trust, Cancer Genetics Unit United Kingdom (2018 to date)
- Tutor, MSc Genomic Medicine, Imperial College London (2016 to date)
- Tutor, MSc Health Sciences, NUI Galway (2012 to date)
- Visiting Scientist, QIMR Berghofer, Brisbane, Australia (2017)
- Research Fellow, Yale School of Medicine, New Haven, Connecticut, USA (2013)
- She is a member of the steering committee of the Cancer Genetics Group of the British Society of Genomic Medicine.
- She is a core tutor of the Molecular Pathology of Cancer and Application in Cancer Diagnosis, Screening, and Treatment Module of the ICR-led MSc in Genomic Medicine (Imperial College London)
- Her specialist training was funded by the Health Research Board/Health Service Executive National Academic SpR Fellowship, with clinical and research fellowships in the Royal Marsden, in Yale University, New Haven, CT, USA, and in QIMR Berghofer, Brisbane Australia.
Rodrigo Dienstmann, M.D., PhD, MBA
- Dr Rodrigo Dienstmann is Principal Investigator of the Oncology Data Science Group of the Vall d’Hebron Institute of Oncology (VHIO) in Barcelona, Spain
- He is also Medical Director of Oncoclínicas Precision Medicine, São Paulo, Brazil
- His research interests include: (i) integration of clinical and translational research with genomics for precision cancer therapy; (ii) clinical-molecular databases of matched targeted agents and standardized reports of next-generation sequencing tests; (iii) collaborative research in cancer genomics/computational oncology and its clinical implications
- Executive Master in Business Administration, Barcelona, Spain
- Post-graduation in Data Science, Sage Bionetworks, Seattle, USA
- Post-graduation in Molecular Pathology, Mass General Hospital, Boston, USA
- Clinical Research in Oncology, Brazilian National Cancer Institute, Rio de Janeiro, Brazil, 2009
- Board Certified in Medical Oncology, National Cancer Institute, Brazil, 2005
- Medical Doctor at Universidade Federal do Rio Grande do Sul, Brazil, 2001
Professional Experience (selected)
- Principal Investigator, Oncology data Science Group, Vall d´Hebron Institute of Oncology, Spain
- Leader, Molecular Prescreening Program for Precision Medicine, Vall d´Hebron Institute of Oncology, Spain
- Research Assistant, Computational Oncology, Sage Bionetworks, Fred Hutchinson Cancer Center, Seattle, USA
- Active member of the European Society of Medical Oncology (ESMO), the American Society of Clinical Oncology (ASCO) and the American Association of Cancer Research (AACR)
- Active member of “Horizon 2020”, the biggest EU Research and Innovation program
- La Caixa International Program for Cancer Research & Education Grant, 2012
- IMPAKT Susan G. Komen for the Cure Award, 2009
- International Development Education Award, 2007
Stephen Finn, MB BAO BCh, FDS, PhD, FRCPath, FFPATH
- Dr. Stephen Finn MB BAO BCh FDS PhD FRCPath FFPATH, is an Associate Professor, Consultant Pathologist and Principal Investigator at The University of Dublin, Trinity College and at St. James’s Hospital Dublin
- Dr. Stephen Finn is an academic Histopathologist with subspecialist interests in genitourinary pathology and cancer molecular diagnostics
- His clinical practice is limited to Molecular, Urological, Gastrointestinal and Liver pathology
- Dr. Finn completed his higher professional training in Dublin in 2005
- He qualified from University College, Cork (UCC) in 1998
Professional Experience (selected)
- He is a former Prostate Cancer Foundation Young Investigator and co-director of the Cancer Molecular Diagnostic Laboratory at St James’s Hospital and Associate Professor of Pathology at the University of Dublin, Trinity College
- He worked as a consultant pathologist at the Mid Western Regional Hospital Limerick
- He worked as Senior Scientist and Staff Pathologist to the Centre for Molecular Oncologic Pathology at the Dana Farber Cancer Institute, Boston, USA
- Dr. Finn is a member of the Irish Prostate Cancer Research Consortium (PCRC) and the Transdisciplinary Prostate Cancer Partnership ToPCaP
- Dr. Finn continues to have strong personal and collaborative links to the Harvard School of Public Health, the Dana Farber Cancer Institute and the University of Orebro in Sweden.
- Translational Chair of Lung group at Cancer Trials Ireland
- Member of European Thoracic Oncology Platform (ETOP)
- Dr. Finn is a current recipient of the Prostate Cancer Foundation Young Investigator Award
Marie-Dominique Galibert, PharmD, PhD
- Prof. Galibert is the Deputy Director of the Institute of Genetics and Development of Rennes (IGDR) and the Head of the Gene Expression and Oncogenesis Research Team – Labellisée Fondation ARC since 2016
- She is also the Head of the Department of Molecular Genetics and Genomics and the Co-Director of the FHU-CAMIn (Hospital University Federation – Cancer Microenvironment Innovation) at the Rennes University Hospital
- Post-Doctoral fellow – Prof. CR GODING Lab, UK – European Marie Curie Fellowship, (1996 – 1999)
- PhD – Pasteur Institute Paris / University Pierre et Marie Curie, PARIS VI, France – MRT Fellowship, 1996
- Pharmaceutical Doctor – University René Descartes, PARIS V, France, 1991
Professional Experience (selected)
- Professor – Hospital Practitioner (PU-PH), Rennes University & Hospital, France, 2010
- HDR – University of Rennes, France, 2007
- Associate Professor – Hospital Practitioner (MCU-PH), Rennes University & Hospital, France, 2000
- Member of the Scientific Board of the LNCC (Ligue National Contre le Cancer), 2020
- Member of the Scientific Board of the IUF (Institut Universitaire de France), 2018
- Head of the Brittany Health Council (CCRRDT DIS5), 2017
- Member of the Rennes University Board of Directors, 2016
- Equipe de Recherche Labélisée Fondation ARC (2016 – 2019 & 2020 – 2022)
- PAIR Melanoma program (2013 – 2016)
- Aviessan research programs (2013-2016 & 2016-2019)
- Organization of the 21th International meeting of the European Society of Pigment Cell Research (ESPCR): Rennes 24-27 September 2018: https://espcr2018.sciencesconf.org
From November 2020 to June 2022, the educational MTB in Ireland has created the following footprint
The treating clinicians 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 clinicians can have an informed discussion during a MTB session.
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:
Our vision is to change the way cancer patients in Ireland are treated building on a Molecular Tumour Board
Driven by Roche
Driven by Roche & Cancer Trials Ireland
Driven by Cancer Trials Ireland (independent from Roche)
Driven by Cancer Trials Ireland
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. 2020 Oct 2;11(1):4965.
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. 2018 Jul 23;3(5):e000398.
Molecular Tumor Board Review and Improved Overall Survival in Non–Small-Cell Lung Cancer.
Huang, Bin, et al., JCO Precision Oncology. 2021 Sep 29(5):1530-1539.
Transitioning the molecular tumor board from proof of concept to clinical routine: a German single-center analysis.
Hoefflin, Rouven, et al. Cancers. 2021 Mar; 13(5):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 Nov;26(11):e1962-e1970.
Molecular tumor board: the University of California San Diego Moores cancer center experience.
Schwaederle, Maria, et al., The Oncologist. 2014 Jun;19(6):631-6.
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. 2015 Sep;20(9):1011-8.
Multicenter comparison of molecular tumor boards in The Netherlands: Definition, composition, methods, and targeted therapy recommendations.
Koopman, Bart, et al., The Oncologist. 2021 Aug; 26(8): e1347-e1358.