Role of the Molecular Tumor Board for the Personalized Treatment of Patients with Metastatic Breast Cancer: A Focus on the State of the Art in Italy

SIMPLE SUMMARY: Molecular tumor boards (MTBs) aim to translate the results of genomic tests into clinical practice in order to set-up the most appropriate therapeutic strategy for the individual patient. Genomic tests represent a challenge for the Italian National Health System, which must set-up new paths for access to medicines and, at the same time, guarantee economic sustainability. Furthermore, the scientific and clinical skills of clinicians must be guaranteed to follow the complex and rapid evolution of cancer genetics and the availability of agnostic anticancer drugs. This review aims to analyze the role of MTBs in the management of patients with metastatic breast cancer (MBC). ABSTRACT: Molecular tumor boards (MTBs) are multidisciplinary groups that combine molecular and clinical data from cancer patients in order to formulate treatment recommendations for precision medicine. To date, there is insufficient data to support the use of singleplex or next-generation sequencing (NGS) technologies to select first-line therapy for patients with metastatic breast cancer (MBC), but considering the high number of level II alterations, according to the ESMO scale for clinical actionability of molecular targets (ESCAT), it is suggested to include patients in molecular screening programs in order to be able to offer targeted therapies for specific genomic alterations. This article aims at reviewing the most recent literature related to the most used methodologies/approaches for molecular diagnostics and variants’ classification, summarizing the internationally published molecular screening studies in support of MTB activity and, in the end, discussing MTBs’ current position and role in Italy, the number of which is increasing, also thanks to the thrust of institutions.