Real-world data from a molecular tumor board demonstrates improved outcomes with a precision N-of-One strategy

Shumei Kato (), Ki Hwan Kim (), Hyo Jeong Lim, Amelie Boichard, Mina Nikanjam, Elizabeth Weihe, Dennis J. Kuo, Ramez N. Eskander, Aaron Goodman, Natalie Galanina, Paul T. Fanta, Richard B. Schwab, Rebecca Shatsky, Steven C. Plaxe, Andrew Sharabi, Edward Stites, Jacob J. Adashek, Ryosuke Okamura, Suzanna Lee, Scott M. Lippman, Jason K. Sicklick and Razelle Kurzrock
Additional contact information
Shumei Kato: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Ki Hwan Kim: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Hyo Jeong Lim: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Amelie Boichard: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Mina Nikanjam: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Elizabeth Weihe: UC San Diego Moores Cancer Center
Dennis J. Kuo: Division of Pediatric Hematology-Oncology, Rady Children’s Hospital-San Diego, University of California San Diego School of Medicine
Ramez N. Eskander: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Aaron Goodman: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Natalie Galanina: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Paul T. Fanta: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Richard B. Schwab: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Rebecca Shatsky: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Steven C. Plaxe: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Andrew Sharabi: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Edward Stites: Integrative Biology Laboratory, Salk Institute for Biological Studies
Jacob J. Adashek: University of South Florida, H. Lee Moffitt Cancer Center & Research Institute
Ryosuke Okamura: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Suzanna Lee: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Scott M. Lippman: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center
Jason K. Sicklick: Center for Personalized Cancer Therapy and Division of Surgical Oncology, Department of Surgery, UC San Diego Moores Cancer Center
Razelle Kurzrock: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, Department of Medicine, UC San Diego Moores Cancer Center

Nature Communications, 2020, vol. 11, issue 1, 1-9

Abstract: Abstract Next-generation sequencing (NGS) can identify novel cancer targets. However, interpreting the molecular findings and accessing drugs/clinical trials is challenging. Furthermore, many tumors show resistance to monotherapies. To implement a precision strategy, we initiated a multidisciplinary (basic/translational/clinical investigators, bioinformaticians, geneticists, and physicians from multiple specialties) molecular tumor board (MTB), which included a project manager to facilitate obtaining clinical-grade biomarkers (blood/tissue NGS, specific immunohistochemistry/RNA expression including for immune-biomarkers, per physician discretion) and medication-acquisition specialists/clinical trial coordinators/navigators to assist with medication access. The MTB comprehensively reviewed patient characteristics to develop N-of-One treatments implemented by the treating physician’s direction under the auspices of a master protocol. Overall, 265/429 therapy-evaluable patients (62%) were matched to ≥1 recommended drug. Eighty-six patients (20%) matched to all drugs recommended by MTB, including combinatorial approaches, while 38% received physician’s choice regimen, generally with unmatched approach/low degree of matching. Our results show that patients who receive MTB-recommended regimens (versus physician choice) have significantly longer progression-free (PFS) and overall survival (OS), and are better matched to therapy. High (≥50%) versus low (

Date: 2020
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DOI: 10.1038/s41467-020-18613-3

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