分子肿瘤板 - 精准肿瘤学当前和未来的考虑因素。
Molecular tumour boards - current and future considerations for precision oncology.
发表日期:2023 Oct 16
作者:
Apostolia M Tsimberidou, Michael Kahle, Henry Hiep Vo, Mehmet A Baysal, Amber Johnson, Funda Meric-Bernstam
来源:
Nature Reviews Clinical Oncology
摘要:
在过去的 15 年里,发育疗法取得了快速进展,特别是在使用匹配的靶向疗法来对抗各种癌症类型的特定致癌分子改变方面。分子肿瘤委员会 (MTB) 是由专家医生、科学家、医疗保健提供者和患者权益倡导者组成的小组,他们审查和解释个体癌症患者的分子分析结果,并将每位患者与可用的疗法相匹配,其中可能包括研究药物。解释每个患者中发现的分子改变是一项复杂的任务,需要了解它们的背景功能效应及其与对特定治疗的敏感性或耐药性的相关性。确定分子改变的可操作性和选择匹配治疗的标准在不断发展。因此,MTB在优化生物标志物导向疗法的分配和精准肿瘤学的实施方面发挥着越来越重要的作用。最终,MTB 可用性、可及性和性能的提高可能会改善患者护理。由于个体患者肿瘤中存在大量可识别的分子改变和免疫标记物,并且随着越来越多的患者结局数据和临床试验结果的出现,其临床意义不断变化,MTB 面临的挑战正在日益增加。除了下一代测序之外,更广泛的生物标志物分析可以提供有用的信息。然而,需要更多的资金、资源和专业知识来确保 MTB 的可持续性并将其覆盖范围扩大到服务不足的人群。为了最佳地实施精准肿瘤学,需要实践和政策之间的协调。在此,我们讨论 MTB 不断发展的作用以及其在精准肿瘤学中使用的当前和未来考虑因素。© 2023。Springer Nature Limited。
Over the past 15 years, rapid progress has been made in developmental therapeutics, especially regarding the use of matched targeted therapies against specific oncogenic molecular alterations across cancer types. Molecular tumour boards (MTBs) are panels of expert physicians, scientists, health-care providers and patient advocates who review and interpret molecular-profiling results for individual patients with cancer and match each patient to available therapies, which can include investigational drugs. Interpretation of the molecular alterations found in each patient is a complicated task that requires an understanding of their contextual functional effects and their correlations with sensitivity or resistance to specific treatments. The criteria for determining the actionability of molecular alterations and selecting matched treatments are constantly evolving. Therefore, MTBs have an increasingly necessary role in optimizing the allocation of biomarker-directed therapies and the implementation of precision oncology. Ultimately, increased MTB availability, accessibility and performance are likely to improve patient care. The challenges faced by MTBs are increasing, owing to the plethora of identifiable molecular alterations and immune markers in tumours of individual patients and their evolving clinical significance as more and more data on patient outcomes and results from clinical trials become available. Beyond next-generation sequencing, broader biomarker analyses can provide useful information. However, greater funding, resources and expertise are needed to ensure the sustainability of MTBs and expand their outreach to underserved populations. Harmonization between practice and policy will be required to optimally implement precision oncology. Herein, we discuss the evolving role of MTBs and current and future considerations for their use in precision oncology.© 2023. Springer Nature Limited.