ESMO Open. 2018 Apr 6;3(3):e000339. doi: 10.1136/esmoopen-2018-000339. eCollection 2018.
Relevance of a molecular tumour board (MTB) for patients' enrolment in clinical trials: experience of the Institut Curie.
Basse C#1, Morel C#1, Alt M1, Sablin MP1, Franck C2, Pierron G2, Callens C2, Melaabi S2, Masliah-Planchon J2, Bataillon G2, Gardrat S2, Lavigne M2, Bonsang B2, Vaflard P1, Pons Tostivint E1, Dubot C1, Loirat D1, Marous M1, Geiss R1, Clément N3, Schleiermacher G3, Kamoun C4, Girard E4, Ardin M4, Benoist C2, Bernard V2, Mariani O2, Rouzier R4,5, Tresca P1, Servois V6, Vincent-Salomon A2, Bieche I2,7, Le Tourneau C1,4,8, Kamal M1.
High throughput molecular screening techniques allow the identification of multiple molecular alterations, some of which are actionable and can be targeted by molecularly targeted agents (MTA). We aimed at evaluating the relevance of using this approach in the frame of Institut Curie Molecular Tumor Board (MTB) to guide patients with cancer to clinical trials with MTAs.
PATIENTS AND METHODS:
We included all patients presented at Institut Curie MTB from 4 October 2014 to 31 October 2017. The following information was extracted from the chart: decision to perform tumour profiling, types of molecular analyses, samples used, molecular alterations identified and those which are actionable, and inclusion in a clinical trial with matched MTA.
736 patients were presented at the MTB. Molecular analyses were performed in 442 patients (60%). Techniques used included next-generation sequencing, comparative genomic hybridisation array and/or other techniques including immunohistochemistry in 78%, 51% and 58% of patients, respectively. Analyses were performed on a fresh frozen biopsy in 91 patients (21%), on archival tissue (fixed or frozen) in 326 patients (74%) and on both archival and fresh frozen biopsy in 25 patients (6%). At least one molecular alteration was identified in 280 analysed patients (63%). An actionable molecular alteration was identified in 207 analysed patients (47%). Forty-five analysed patients (10%) were enrolled in a clinical trial with matched MTA and 29 additional patients were oriented and included in a clinical trial based on a molecular alteration identified prior to the MTB analysis. Median time between date of specimen reception and molecular results was 28 days (range: 5-168).
The implementation of an MTB at Institut Curie enabled the inclusion of 10% of patients into a clinical trial with matched therapy.
clinical trials; molecular tumour board; targeted therapy; tumour profiling