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Virtual Molecular Tumor Boards May Help to Efficiently Deliver Precision Medicine to Patients


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Using virtual, cloud-based, interconnected computing techniques applied to 51,000 variables, researchers reduced the time needed to assess a patient’s tumor profile and suitability for clinical trials from 14 to 4 days. This method also increased the number of cases that could be assessed compared to conventional methods by twofold over a 4-year period. These findings were published by Pishvaian et al in the Journal of the American Medical Informatics Association (JAMIA).

“Our platform is unique in that it integrates patient-specific data with genomic knowledge bases to provide a comprehensive report on potential trial enrollment opportunities,” said corresponding study author Subha Madhavan, PhD, FACMI, Chief Data Scientist and Director of the Innovation Center for Biomedical Informatics at Georgetown University Medical Center. “While the majority of the cases we examined were in pancreatic cancer, our platform was designed to be applicable to any type of advanced cancer.”

Methods

In their study, the researchers modeled virtual molecular tumor boards to assess the genetic makeup, previous treatment history, and other factors for 1,725 patients with cancer. They also compared virtual molecular tumor boards outcomes with reviews by five gastrointestinal oncologists who performed tumor board duties in a conventional manner. The time spent assessing appropriate trials was noted, and the results were compared to the virtual method.

Over a 4-year period, the investigators found that virtual boards could make assessments based on patient tumors for over 2,000 clinical trials, more than 1,000 cancer drugs, and nearly 200 genetic biomarkers associated with targets known to be amenable to treatment. From 2014 to 2017, the number of cases assessed virtually increased from 46 to 622, compared to conventional board assessments going from 3 cases to 14.


“As cancer diagnoses and treatment become more data driven and complex, a virtual molecular tumor board allows for deep discussions and insight into many aspects of a person’s unique cancer profile."
— Michael J. Pishvaian, MD, PhD

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Additionally, the virtual board process integrated comprehensive information about the distance between a patient and a potential treatment center, providing practical resources for a patient looking for a clinical trial. Notably, fewer than 5% of patients with pancreatic cancer currently enroll in clinical trials, but 22% of such patients whose cases were reviewed by a virtual board enrolled in a clinical trial.

“As cancer diagnoses and treatment become more data driven and complex, a virtual molecular tumor board allows for deep discussions and insight into many aspects of a person’s unique cancer profile,” said co-first study author Michael J. Pishvaian, MD, PhD, Associate Professor in the Department of Gastrointestinal Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston. “Additionally, while there are just a few immunotherapy-related biomarkers currently known for all types of cancer, virtual molecular tumor boards have tremendous potential, when new biomarkers are discovered, to assist in finding patients the best possible clinical trials for their treatment.

Disclosure: For full disclosures of the study authors, visit academic.oup.com.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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