COMMENTARY

The Molecular Tumor Board

Molecular Testing When Standard-of-Care Options Are Not Available

Maurie Markman, MD

Disclosures

July 22, 2014

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Hello. I am Dr. Maurie Markman, from Cancer Treatment Centers of America in Philadelphia, Pennsylvania. I want to briefly discuss a topic that is probably on the minds of a number of oncologists as they consider the potential for ordering molecular testing.

Molecular testing is increasingly available through a variety of companies, strategies, and platforms to a population of individuals who do not currently have access to standard-of-care options. In other words, these patients have had standard therapies; the physician knows the potential exists that a molecular abnormality may be found by one of these tests. They wonder, "If I order this test, when I receive the results, who can help me with some of this very complicated, very exciting world of molecular analysis?"

Molecular Tumor Board in Practice

One potential strategy is for an institution or a group of institutions to put together what could be called a molecular tumor board. An example of this was recently reported in the journal The Oncologist,[1] in which a group at the University of California, San Diego, discusses an initial experience with the use of molecular testing.

This very interesting paper described 34 patients who had received many previous therapies. A number of molecular abnormalities were found in these patients, and a group including oncologists (who understand this world), pathologists, and others made treatment recommendations. Of the 11 patients who received treatment that was informed by the molecular diagnostics, 3 patients achieved a partial remission.

Obviously, this was not a randomized trial. No one knows for certain that these patients would not have responded to other therapies, but clearly this is an interesting example of how one might take the expertise of the oncology community, put together a molecular tumor board, and use the brain power of the group to help inform treatment decisions that clearly have the potential to benefit individual patients. I encourage you to read this interesting paper. One can be fairly certain that we will see more reports like this in the very near future.

I thank you for your attention.

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