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  • 1
    In: The Lancet, Elsevier BV, Vol. 397, No. 10272 ( 2021-01), p. 387-397
    Type of Medium: Online Resource
    ISSN: 0140-6736
    RVK:
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
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    detail.hit.zdb_id: 3306-6
    detail.hit.zdb_id: 1476593-7
    SSG: 5,21
    Location Call Number Limitation Availability
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  • 2
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 16_suppl ( 2022-06-01), p. e18623-e18623
    Abstract: e18623 Background: As precision oncology evolves, a growing number of physicians refer cancer patients for CTMP. Oftentimes, CTMP cannot be performed at local centers and patients turn to third-party facilities or commercial solutions. CTMP findings summarized in molecular profiling reports are used by physicians as a basis for MTB. Methods: A molecular tumor board was developed at our cancer center for patients who had undergone CTMP via NGS. Before each MTB, experts in cancer biology and bioinformatics performed reported alteration annotation, interpretation and critical evidence evaluation for each patient, not taking into account the recommendations provided in the original CTMP reports. Results: In total, 29 patients with various tumor types (31% CRC, 25% NSCLC, 10% SOC, 8% Breast; 26% other) who had undergone CTMP in a third-party for-profit organization (2 international, 4 Russian based organizations) were evaluated for discussion at MTB. In 4 CTMP reports therapy recommendations were compiled at odds with principles of evidence-based medicine and did not contain information on detected molecular alteration and, thus, these patients were not discussed within MTB. In 48% (12/25) of reports discussed within MTB, ranking of genomic findings based on potential clinical evidence and actionability was not provided. 24% (6/25) of the reports did not comply with the ASCO recommendations on genomic findings reporting in oncology. In 8 (32%) reports, only drug classes and not specific drugs were recommended. A total of 362 alterations were identified in 25 CTMP reports. Of those, 93 (26%) were not annotated according to the well-established HGVS nomenclature of sequence variants. Out of these 93, 32 (34%) could not be further identified using various genomic tools. Following our interpretation of the reported variants, 16 (4.4%) of the reported variants were found to be benign and, in fact, well-established population polymorphisms (gnomAD MAF 〉 1%). Only in 40% (10/25) of the reports, genomic alterations were classified based on their origin (somatic/likely germline). For 10 patients, 18 additional therapy options were recommended. Finally, 3-4 hours of preparatory work was required in order to reevaluate the reported findings following CTMP. Conclusions: As tumor molecular profiling becomes a more available tool for precision oncology, the number of patients requiring treatment strategy correction increases. Specific treatment plans can be set up following a discussion within a multidisciplinary team at MTB. Due to the lack of standardization of molecular profiling reporting, thorough preparatory work by experts trained in cancer biology is required before each MTB. Such preliminary work ensures time efficient discussion at MTB, requiring no more than 15 minutes of the physician’s time.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
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  • 3
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 40, No. 16_suppl ( 2022-06-01), p. e15119-e15119
    Abstract: e15119 Background: With the spread of CTMP in cancer patient management and expansion of molecular-targeted treatment opportunities, resources for quick and efficient molecular profile interpretation are in high demand. Number of public KBs have been introduced. We analysed their utility to compile per patient treatment recommendations. Methods: Analysis was performed across patients, who underwent CTMP. Based on the reported molecular alterations, interpretation and critical evidence evaluation was performed not taking into account the recommendations provided in the original CTMP reports. Therapy recommendations were ranked according to ESCAT. Resistance biomarkers were ranked according to OncoKB V2 level of evidence system. OncoKB, CIViC, CGI, CGA, VICC and MolecularMatch were assessed. KBs were assessed through API or local copy of KB. Results: A total of 222 CTMP reports from 222 patients (35% - NSCLC; 24% - CRC; 8% - pancreas; 7% - breast; 4% - gastric; 22% - other) were analysed. CTMP was performed in Foundation Medicine (82%) or Atlas Oncology Diagnostics (18%). Across 222 patients 932 molecular alterations were identified. A total of 1394 therapy recommendations were compiled associated with 368 molecular alteration across 171 (77%) patients (112 recommendations ESCAT level I; 908 - ESCAT III-IV; 70 - OncoKB R1). Across 181 ESCAT-I/R1 therapy recommendations 172 (95%) were present in at least 1 KB (92% for ESCAT-I recommendations, 100% - R1) with the VICC providing the highest rate of retrieval (80%), followed by OncoKB (78%), MolecularMatch (70%), CIViC - (69%) and CGI (69%). Only 92 (53%) of ESCAT-I/R1 therapy recommendations were present in all KBs. Across 27 patients with ESCAT-I recommendations, at least 1 therapy recommendation was retrieved in any KB for all patients. ESCAT II-IV therapy recommendations were provided for 161 patients and grouped by drug class, resulting in 457 [biomarker]-[drug class] associations. Of them 346 (75%) were present in at least 1 KB with the VICC providing the highest rate of retrieval (69%), followed by CGI (61%), CGA (56%), OncoKB (48%), CIViC (48%) and MolecularMatch (45%). Of 161 patients, for 24 (15%) no recommendations were retrieved in any KB for any biomarker identified. For random 15 (a total of 68 molecular alterations) patients KBs were assessed manually in order to estimate the average time in use. CGI was the most easily accessible (3.2 min per patient in average), following by CGA (5.6 min), OncoKB (7.2 min), CIViC (26.2 min), and VICC (35.9 min). Conclusions: Public KBs provide substantial information on ESCAT-I/R1 biomarkers and decent information on ESCAT II-IV biomarkers, reasoning manual curation. VICC provided the most complete information, though was thorough for manual use. The use of multiple KBs may significantly improve retrieval results, though is time-consuming and results in excess of misleading/outdated recommendations.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2022
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
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