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Programmatic Precision Oncology Decision Support for Patients With Gastrointestinal Cancer
With the growing number of available targeted therapeutics and molecular biomarkers, the optimal care of patients with cancer now depends on a comprehensive understanding of the rapidly evolving landscape of precision oncology, which can be challenging for oncologists to navigate alone. METHODS: We...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9929103/ https://www.ncbi.nlm.nih.gov/pubmed/36634297 http://dx.doi.org/10.1200/PO.22.00342 |
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author | Keller, Rachel B. Mazor, Tali Sholl, Lynette Aguirre, Andrew J. Singh, Harshabad Sethi, Nilay Bass, Adam Nagaraja, Ankur K. Brais, Lauren K. Hill, Emma Hennessey, Connor Cusick, Margaret Del Vecchio Fitz, Catherine Zwiesler, Zachary Siegel, Ethan Ovalle, Andrea Trukhanov, Pavel Hansel, Jason Shapiro, Geoffrey I. Abrams, Thomas A. Biller, Leah H. Chan, Jennifer A. Cleary, James M. Corsello, Steven M. Enzinger, Andrea C. Enzinger, Peter C. Mayer, Robert J. McCleary, Nadine J. Meyerhardt, Jeffrey A. Ng, Kimmie Patel, Anuj K. Perez, Kimberley J. Rahma, Osama E. Rubinson, Douglas A. Wisch, Jeffrey S. Yurgelun, Matthew B. Hassett, Michael J. MacConaill, Laura Schrag, Deborah Cerami, Ethan Wolpin, Brian M. Nowak, Jonathan A. Giannakis, Marios |
author_facet | Keller, Rachel B. Mazor, Tali Sholl, Lynette Aguirre, Andrew J. Singh, Harshabad Sethi, Nilay Bass, Adam Nagaraja, Ankur K. Brais, Lauren K. Hill, Emma Hennessey, Connor Cusick, Margaret Del Vecchio Fitz, Catherine Zwiesler, Zachary Siegel, Ethan Ovalle, Andrea Trukhanov, Pavel Hansel, Jason Shapiro, Geoffrey I. Abrams, Thomas A. Biller, Leah H. Chan, Jennifer A. Cleary, James M. Corsello, Steven M. Enzinger, Andrea C. Enzinger, Peter C. Mayer, Robert J. McCleary, Nadine J. Meyerhardt, Jeffrey A. Ng, Kimmie Patel, Anuj K. Perez, Kimberley J. Rahma, Osama E. Rubinson, Douglas A. Wisch, Jeffrey S. Yurgelun, Matthew B. Hassett, Michael J. MacConaill, Laura Schrag, Deborah Cerami, Ethan Wolpin, Brian M. Nowak, Jonathan A. Giannakis, Marios |
author_sort | Keller, Rachel B. |
collection | PubMed |
description | With the growing number of available targeted therapeutics and molecular biomarkers, the optimal care of patients with cancer now depends on a comprehensive understanding of the rapidly evolving landscape of precision oncology, which can be challenging for oncologists to navigate alone. METHODS: We developed and implemented a precision oncology decision support system, GI TARGET, (Gastrointestinal Treatment Assistance Regarding Genomic Evaluation of Tumors) within the Gastrointestinal Cancer Center at the Dana-Farber Cancer Institute. With a multidisciplinary team, we systematically reviewed tumor molecular profiling for GI tumors and provided molecularly informed clinical recommendations, which included identifying appropriate clinical trials aided by the computational matching platform MatchMiner, suggesting targeted therapy options on or off the US Food and Drug Administration–approved label, and consideration of additional or orthogonal molecular testing. RESULTS: We reviewed genomic data and provided clinical recommendations for 506 patients with GI cancer who underwent tumor molecular profiling between January and June 2019 and determined follow-up using the electronic health record. Summary reports were provided to 19 medical oncologists for patients with colorectal (n = 198, 39%), pancreatic (n = 124, 24%), esophagogastric (n = 67, 13%), biliary (n = 40, 8%), and other GI cancers. We recommended ≥ 1 precision medicine clinical trial for 80% (406 of 506) of patients, leading to 24 enrollments. We recommended on-label and off-label targeted therapies for 6% (28 of 506) and 25% (125 of 506) of patients, respectively. Recommendations for additional or orthogonal testing were made for 42% (211 of 506) of patients. CONCLUSION: The integration of precision medicine in routine cancer care through a dedicated multidisciplinary molecular tumor board is scalable and sustainable, and implementation of precision oncology recommendations has clinical utility for patients with cancer. |
format | Online Article Text |
id | pubmed-9929103 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-99291032023-02-16 Programmatic Precision Oncology Decision Support for Patients With Gastrointestinal Cancer Keller, Rachel B. Mazor, Tali Sholl, Lynette Aguirre, Andrew J. Singh, Harshabad Sethi, Nilay Bass, Adam Nagaraja, Ankur K. Brais, Lauren K. Hill, Emma Hennessey, Connor Cusick, Margaret Del Vecchio Fitz, Catherine Zwiesler, Zachary Siegel, Ethan Ovalle, Andrea Trukhanov, Pavel Hansel, Jason Shapiro, Geoffrey I. Abrams, Thomas A. Biller, Leah H. Chan, Jennifer A. Cleary, James M. Corsello, Steven M. Enzinger, Andrea C. Enzinger, Peter C. Mayer, Robert J. McCleary, Nadine J. Meyerhardt, Jeffrey A. Ng, Kimmie Patel, Anuj K. Perez, Kimberley J. Rahma, Osama E. Rubinson, Douglas A. Wisch, Jeffrey S. Yurgelun, Matthew B. Hassett, Michael J. MacConaill, Laura Schrag, Deborah Cerami, Ethan Wolpin, Brian M. Nowak, Jonathan A. Giannakis, Marios JCO Precis Oncol ORIGINAL REPORTS With the growing number of available targeted therapeutics and molecular biomarkers, the optimal care of patients with cancer now depends on a comprehensive understanding of the rapidly evolving landscape of precision oncology, which can be challenging for oncologists to navigate alone. METHODS: We developed and implemented a precision oncology decision support system, GI TARGET, (Gastrointestinal Treatment Assistance Regarding Genomic Evaluation of Tumors) within the Gastrointestinal Cancer Center at the Dana-Farber Cancer Institute. With a multidisciplinary team, we systematically reviewed tumor molecular profiling for GI tumors and provided molecularly informed clinical recommendations, which included identifying appropriate clinical trials aided by the computational matching platform MatchMiner, suggesting targeted therapy options on or off the US Food and Drug Administration–approved label, and consideration of additional or orthogonal molecular testing. RESULTS: We reviewed genomic data and provided clinical recommendations for 506 patients with GI cancer who underwent tumor molecular profiling between January and June 2019 and determined follow-up using the electronic health record. Summary reports were provided to 19 medical oncologists for patients with colorectal (n = 198, 39%), pancreatic (n = 124, 24%), esophagogastric (n = 67, 13%), biliary (n = 40, 8%), and other GI cancers. We recommended ≥ 1 precision medicine clinical trial for 80% (406 of 506) of patients, leading to 24 enrollments. We recommended on-label and off-label targeted therapies for 6% (28 of 506) and 25% (125 of 506) of patients, respectively. Recommendations for additional or orthogonal testing were made for 42% (211 of 506) of patients. CONCLUSION: The integration of precision medicine in routine cancer care through a dedicated multidisciplinary molecular tumor board is scalable and sustainable, and implementation of precision oncology recommendations has clinical utility for patients with cancer. Wolters Kluwer Health 2023-01-12 /pmc/articles/PMC9929103/ /pubmed/36634297 http://dx.doi.org/10.1200/PO.22.00342 Text en © 2023 by American Society of Clinical Oncology https://creativecommons.org/licenses/by/4.0/Licensed under the Creative Commons Attribution 4.0 License: http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | ORIGINAL REPORTS Keller, Rachel B. Mazor, Tali Sholl, Lynette Aguirre, Andrew J. Singh, Harshabad Sethi, Nilay Bass, Adam Nagaraja, Ankur K. Brais, Lauren K. Hill, Emma Hennessey, Connor Cusick, Margaret Del Vecchio Fitz, Catherine Zwiesler, Zachary Siegel, Ethan Ovalle, Andrea Trukhanov, Pavel Hansel, Jason Shapiro, Geoffrey I. Abrams, Thomas A. Biller, Leah H. Chan, Jennifer A. Cleary, James M. Corsello, Steven M. Enzinger, Andrea C. Enzinger, Peter C. Mayer, Robert J. McCleary, Nadine J. Meyerhardt, Jeffrey A. Ng, Kimmie Patel, Anuj K. Perez, Kimberley J. Rahma, Osama E. Rubinson, Douglas A. Wisch, Jeffrey S. Yurgelun, Matthew B. Hassett, Michael J. MacConaill, Laura Schrag, Deborah Cerami, Ethan Wolpin, Brian M. Nowak, Jonathan A. Giannakis, Marios Programmatic Precision Oncology Decision Support for Patients With Gastrointestinal Cancer |
title | Programmatic Precision Oncology Decision Support for Patients With Gastrointestinal Cancer |
title_full | Programmatic Precision Oncology Decision Support for Patients With Gastrointestinal Cancer |
title_fullStr | Programmatic Precision Oncology Decision Support for Patients With Gastrointestinal Cancer |
title_full_unstemmed | Programmatic Precision Oncology Decision Support for Patients With Gastrointestinal Cancer |
title_short | Programmatic Precision Oncology Decision Support for Patients With Gastrointestinal Cancer |
title_sort | programmatic precision oncology decision support for patients with gastrointestinal cancer |
topic | ORIGINAL REPORTS |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9929103/ https://www.ncbi.nlm.nih.gov/pubmed/36634297 http://dx.doi.org/10.1200/PO.22.00342 |
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