L. Boscolo Bielo , E. Crimini , M. Repetto , M. Barberis , E. Battaiotto , J. Katrini , E. Martino , G. Gaudio , M. Lombardi , C. Zanzottera , G. Aurilio , C. Belli , Y. Zhan , V. Fuorivia , R.M. Marsicano , J.D. Etessami , P. Zagami , A. Marra , D. Trapani , B. Taurelli Salimbeni , G. Curigliano
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Limited data are available to address the clinical value of implementing MTBs to inform treatment decision making in patients with gastrointestinal (GI) cancers.</div></div><div><h3>Materials and methods</h3><div>We retrospectively retrieved medical records from patients with advanced GI cancers discussed at the European Institute of Oncology’s MTB between August 2019 and December 2024. We evaluated clinical outcomes resulting from applying MGTOs in cancer care according to MTB recommendations, describing real-world progression-free (rwPFS) and overall survival (OS), and used the growth modulation index (GMI) (ratio of PFS<sup>MTB</sup> to PFS<sup>prior</sup>) to quantify the effectiveness of MTB’s recommended cancer treatment in extending PFS.</div></div><div><h3>Results</h3><div>Among 192 patients with GI cancers discussed at MTB, 139 (72.3%) received an MTB treatment recommendation. For patients with available follow-up data (<em>n</em> = 82), 31 patients (41.4%, 17.7% overall) received MGTOs, while 51 patients received standard treatments. Patients receiving MGTOs exhibited a longer rwPFS compared with cases receiving standard therapies [5.35 versus 3.55 months, hazard ratio (HR) 0.62, 95% confidence interval (CI) 0.36-1.08, <em>P =</em> 0.08] and with unmatched cases showing actionable biomarkers but not treated with targeted agents (<em>n</em> = 31) (rwPFS 5.35 versus 2.40 months, HR 0.49, 95% CI 0.27-0.90, <em>P</em> = 0.02). The use of MGTOs resulted in a GMI of 1.12 (interquartile range 0.68-2.36). The European Society for Medical Oncology (ESMO) Scale for Clinical Actionability of molecular Targets (ESCAT) tier I-III treatments resulted in a restricted mean PFS gain of 4.87 months compared with standard therapies (95% CI 1.02-8.72 months, <em>P =</em> 0.01). 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We evaluated clinical outcomes resulting from applying MGTOs in cancer care according to MTB recommendations, describing real-world progression-free (rwPFS) and overall survival (OS), and used the growth modulation index (GMI) (ratio of PFS<sup>MTB</sup> to PFS<sup>prior</sup>) to quantify the effectiveness of MTB’s recommended cancer treatment in extending PFS.</div></div><div><h3>Results</h3><div>Among 192 patients with GI cancers discussed at MTB, 139 (72.3%) received an MTB treatment recommendation. For patients with available follow-up data (<em>n</em> = 82), 31 patients (41.4%, 17.7% overall) received MGTOs, while 51 patients received standard treatments. 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引用次数: 0
摘要
背景：综合基因组图谱（CGP）在临床实践中越来越多地用于指导分子引导治疗方案（MGTOs）的使用。为了优化MGTOs在常规癌症治疗中的整合，已经建立了分子肿瘤委员会（MTBs）。有限的数据可用于解决实施MTBs的临床价值，为胃肠道（GI）癌症患者的治疗决策提供信息。材料和方法：我们回顾性检索了2019年8月至2024年12月期间欧洲肿瘤研究所MTB讨论的晚期胃肠道癌症患者的医疗记录。我们根据MTB建议评估了在癌症治疗中应用MGTOs的临床结果，描述了真实世界无进展（rwPFS）和总生存期（OS），并使用生长调节指数（GMI） （PFSMTB与PFSprior的比率）来量化MTB推荐的癌症治疗在延长PFS方面的有效性。结果：在192例MTB讨论的胃肠道肿瘤患者中，139例（72.3%）接受了MTB治疗建议。在可获得随访数据的患者中（n = 82）， 31例患者（41.4%，总体17.7%）接受了MGTOs治疗，51例患者接受了标准治疗。与接受标准治疗的患者相比，接受MGTOs的患者表现出更长的rwPFS[5.35个月对3.55个月，风险比（HR） 0.62, 95%置信区间（CI） 0.36-1.08, P = 0.08]，与未接受靶向药物治疗的未匹配病例（n = 31）相比（rwPFS 5.35个月对2.40个月，HR 0.49, 95% CI 0.27-0.90, P = 0.02）。MGTOs的使用导致GMI为1.12（四分位数范围为0.68-2.36）。欧洲肿瘤医学学会（ESMO）分子靶点临床可操作性量表（ESCAT） I-III级治疗与标准治疗相比，平均PFS增加了4.87个月（95% CI 1.02-8.72个月，P = 0.01）。接受MGTOs和标准治疗的患者无OS差异（P = 0.89）。结论：我们的研究结果表明，mtb知情的临床决策可以为晚期胃肠道癌症患者提供有价值的临床益处和扩展的治疗选择。
Molecular tumour board in gastrointestinal cancers
Background
Comprehensive genomic profiling (CGP) is being increasingly adopted in clinical practice to guide the use of molecularly guided treatment options (MGTOs). To optimize the integration of MGTOs in routine cancer care, molecular tumour boards (MTBs) have been established. Limited data are available to address the clinical value of implementing MTBs to inform treatment decision making in patients with gastrointestinal (GI) cancers.
Materials and methods
We retrospectively retrieved medical records from patients with advanced GI cancers discussed at the European Institute of Oncology’s MTB between August 2019 and December 2024. We evaluated clinical outcomes resulting from applying MGTOs in cancer care according to MTB recommendations, describing real-world progression-free (rwPFS) and overall survival (OS), and used the growth modulation index (GMI) (ratio of PFSMTB to PFSprior) to quantify the effectiveness of MTB’s recommended cancer treatment in extending PFS.
Results
Among 192 patients with GI cancers discussed at MTB, 139 (72.3%) received an MTB treatment recommendation. For patients with available follow-up data (n = 82), 31 patients (41.4%, 17.7% overall) received MGTOs, while 51 patients received standard treatments. Patients receiving MGTOs exhibited a longer rwPFS compared with cases receiving standard therapies [5.35 versus 3.55 months, hazard ratio (HR) 0.62, 95% confidence interval (CI) 0.36-1.08, P = 0.08] and with unmatched cases showing actionable biomarkers but not treated with targeted agents (n = 31) (rwPFS 5.35 versus 2.40 months, HR 0.49, 95% CI 0.27-0.90, P = 0.02). The use of MGTOs resulted in a GMI of 1.12 (interquartile range 0.68-2.36). The European Society for Medical Oncology (ESMO) Scale for Clinical Actionability of molecular Targets (ESCAT) tier I-III treatments resulted in a restricted mean PFS gain of 4.87 months compared with standard therapies (95% CI 1.02-8.72 months, P = 0.01). No OS difference was observed between patients receiving MGTOs and standard treatments (P = 0.89).
Conclusions
Our results suggest that MTB-informed clinical decision making could provide valuable clinical benefits and expanded therapeutic options in patients affected by advanced GI cancers.
期刊介绍：
ESMO Open is the online-only, open access journal of the European Society for Medical Oncology (ESMO). It is a peer-reviewed publication dedicated to sharing high-quality medical research and educational materials from various fields of oncology. The journal specifically focuses on showcasing innovative clinical and translational cancer research.
ESMO Open aims to publish a wide range of research articles covering all aspects of oncology, including experimental studies, translational research, diagnostic advancements, and therapeutic approaches. The content of the journal includes original research articles, insightful reviews, thought-provoking editorials, and correspondence. Moreover, the journal warmly welcomes the submission of phase I trials and meta-analyses. It also showcases reviews from significant ESMO conferences and meetings, as well as publishes important position statements on behalf of ESMO.
Overall, ESMO Open offers a platform for scientists, clinicians, and researchers in the field of oncology to share their valuable insights and contribute to advancing the understanding and treatment of cancer. The journal serves as a source of up-to-date information and fosters collaboration within the oncology community.
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