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Scheiter A, Hierl F, Lüke F, Keil F, Heudobler D, Einhell S, Klier-Richter M, Konstandin NP, Weber F, Scheiter A, Kandulski A, Schlosser S, Cosma LS, Tews H, Weiss ARR, Grube M, Bumes E, Hau P, Proescholdt M, Steger F, Troeger A, Haferkamp S, Reibenspies LE, Schnabel MJ, Schulz C, Drexler K, Hatzipanagiotou ME, Seitz S, Klinkhammer-Schalke M, Unberath P, Calvisi DF, Pukrop T, Dietmaier W, Evert M, Utpatel K. Critical evaluation of molecular tumour board outcomes following 2 years of clinical practice in a Comprehensive Cancer Centre. Br J Cancer 2023; 128:1134-1147. [PMID: 36572733 PMCID: PMC10006213 DOI: 10.1038/s41416-022-02120-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/05/2022] [Accepted: 12/12/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Recently, molecular tumour boards (MTBs) have been integrated into the clinical routine. Since their benefit remains debated, we assessed MTB outcomes in the Comprehensive Cancer Center Ostbayern (CCCO) from 2019 to 2021. METHODS AND RESULTS In total, 251 patients were included. Targeted sequencing was performed with PCR MSI-evaluation and immunohistochemistry for PD-L1, Her2, and mismatch repair enzymes. 125 treatment recommendations were given (49.8%). High-recommendation rates were achieved for intrahepatic cholangiocarcinoma (20/30, 66.7%) and gastric adenocarcinoma (10/16, 62.5%) as opposed to colorectal cancer (9/36, 25.0%) and pancreatic cancer (3/18, 16.7%). MTB therapies were administered in 47 (18.7%) patients, while 53 (21.1%) received alternative treatment regimens. Thus 37.6% of recommended MTB therapies were implemented (47/125 recommendations). The clinical benefit rate (complete + partial + mixed response + stable disease) was 50.0% for MTB and 63.8% for alternative treatments. PFS2/1 ratios were 34.6% and 16.1%, respectively. Significantly improved PFS could be achieved for m1A-tier-evidence-based MTB therapies (median 6.30 months) compared to alternative treatments (median 2.83 months; P = 0.0278). CONCLUSION The CCCO MTB yielded a considerable recommendation rate, particularly in cholangiocarcinoma patients. The discrepancy between the low-recommendation rates in colorectal and pancreatic cancer suggests the necessity of a weighted prioritisation of entities. High-tier recommendations should be implemented predominantly.
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Affiliation(s)
- Alexander Scheiter
- Institute of Pathology, University of Regensburg, 93053, Regensburg, Germany. .,Bavarian Center for Cancer Research / BZKF, Regensburg, Bavaria, Germany.
| | - Frederik Hierl
- Institute of Pathology, University of Regensburg, 93053, Regensburg, Germany
| | - Florian Lüke
- Bavarian Center for Cancer Research / BZKF, Regensburg, Bavaria, Germany.,Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, 93053, Regensburg, Germany.,Fraunhofer-Institut für Toxikologie und Experimentelle Medizin ITEM-R, Abteilung für personalisierte Onkologie, 93053, Regensburg, Germany
| | - Felix Keil
- Institute of Pathology, University of Regensburg, 93053, Regensburg, Germany
| | - Daniel Heudobler
- Bavarian Center for Cancer Research / BZKF, Regensburg, Bavaria, Germany.,Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, 93053, Regensburg, Germany
| | - Sabine Einhell
- Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, 93053, Regensburg, Germany
| | | | - Nikola P Konstandin
- Institute of Pathology, University of Regensburg, 93053, Regensburg, Germany.,Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, 93053, Regensburg, Germany
| | - Florian Weber
- Institute of Pathology, University of Regensburg, 93053, Regensburg, Germany
| | - Andrea Scheiter
- School of Engineering and Design, Chair of Ergonomics, Technical University of Munich, 85748, Garching, Germany
| | - Arne Kandulski
- Department of Internal Medicine I, University Hospital Regensburg, 93053, Regensburg, Germany
| | - Sophie Schlosser
- Department of Internal Medicine I, University Hospital Regensburg, 93053, Regensburg, Germany
| | - Lidia-Sabina Cosma
- Department of Internal Medicine I, University Hospital Regensburg, 93053, Regensburg, Germany
| | - Hauke Tews
- Department of Internal Medicine I, University Hospital Regensburg, 93053, Regensburg, Germany
| | - Andreas R R Weiss
- Department of Surgery, University Hospital Regensburg, 93053, Regensburg, Germany
| | - Matthias Grube
- Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, 93053, Regensburg, Germany
| | - Elisabeth Bumes
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, 93053 Regensburg University Hospital, 93053, Regensburg, Germany
| | - Peter Hau
- Department of Neurology and Wilhelm Sander-NeuroOncology Unit, 93053 Regensburg University Hospital, 93053, Regensburg, Germany
| | - Martin Proescholdt
- Department of Neurosurgery, University Hospital Regensburg, 93053, Regensburg, Germany
| | - Felix Steger
- Department of Radiotherapy, Regensburg University Medical Center, 93053, Regensburg, Germany
| | - Anja Troeger
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Hospital of Regensburg, 93053, Regensburg, Germany
| | - Sebastian Haferkamp
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Lucas E Reibenspies
- Institute of Pathology, University of Regensburg, 93053, Regensburg, Germany
| | - Marco J Schnabel
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, 93053, Regensburg, Germany
| | - Christian Schulz
- Department of Pneumology, University Hospital Regensburg, 93053, Regensburg, Germany
| | - Konstantin Drexler
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Maria E Hatzipanagiotou
- University Medical Centre Regensburg, Department of Gynecology and Obstetrics, 93053, Regensburg, Germany
| | - Stephan Seitz
- University Medical Centre Regensburg, Department of Gynecology and Obstetrics, 93053, Regensburg, Germany
| | - Monika Klinkhammer-Schalke
- Tumour Center-Institute for Quality Management and Health Services Research, University of Regensburg, 93053, Regensburg, Germany
| | - Philipp Unberath
- Friedrich-Alexander University Erlangen-Nuremberg, Chair of Medical Informatics, 91054, Erlangen, Germany
| | - Diego F Calvisi
- Institute of Pathology, University of Regensburg, 93053, Regensburg, Germany
| | - Tobias Pukrop
- Bavarian Center for Cancer Research / BZKF, Regensburg, Bavaria, Germany.,Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, 93053, Regensburg, Germany.,Fraunhofer-Institut für Toxikologie und Experimentelle Medizin ITEM-R, Abteilung für personalisierte Onkologie, 93053, Regensburg, Germany
| | - Wolfgang Dietmaier
- Institute of Pathology, University of Regensburg, 93053, Regensburg, Germany
| | - Matthias Evert
- Institute of Pathology, University of Regensburg, 93053, Regensburg, Germany
| | - Kirsten Utpatel
- Institute of Pathology, University of Regensburg, 93053, Regensburg, Germany
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