Genomic Tumor Board Review for Cancer
Palo Alto (17 mi)Overseen byJens Rueter
Age: 18+
Sex: Any
Travel: May be covered
Time Reimbursement: Varies
Trial Phase: N/A
Recruiting
Sponsor: Southwest Oncology Group
No Placebo Group
Trial Summary
What is the purpose of this trial?This clinical trial studies how well an educationally enhanced genomic tumor board (EGTB) intervention works to increase the number of patients with solid tumors that have come back (recurrent), do not respond to treatment (refractory), have spread to other parts of the body (metastatic), or are newly diagnosed and spread to other parts of the body (advanced) who receive genome-informed treatment. Genome-informed treatment refers to treatment based on the information found in genomic tumor test results. This study compares the usual approach to reviewing genomic tumor test results with the approach of having a genomic tumor board (GTB) review the test results. A GTB is team of doctors and scientists that have experience in understanding genomic changes and review genomic tumor test results. The tumor board helps to suggest whether there are other cancer treatment options based on patient genetic test results. The usual approach is to review genomic tumor test results without the GTB being involved. This study may help researchers learn if using a GTB enhances the treatment decision making process within 6 months of joining the study. This study may also help researchers learn if using the GTB increases doctors' understanding of genomic tumor test results and increases doctors' comfort level with genomic tumor tests.
What data supports the idea that Genomic Tumor Board Review for Cancer is an effective treatment?The available research shows that Genomic Tumor Board Reviews, which involve experts discussing and interpreting genetic information from cancer patients, can provide useful treatment recommendations. For example, in a community setting, these boards gave 837 actionable recommendations for cancer treatment, and between 36% to 78% of these were followed by doctors. This suggests that the boards help doctors make informed decisions about patient care. Additionally, they improve access to targeted therapies, which are treatments specifically designed to target cancer cells based on their genetic makeup. This approach can be more effective than traditional treatments because it is tailored to the individual patient's cancer.245810
Do I need to stop my current medications to join the trial?The trial protocol does not specify whether you need to stop taking your current medications. However, since the trial involves genomic tumor testing and potential changes in cancer treatment, it's best to discuss your current medications with your doctor to see if any adjustments are needed.
Is Genomic Tumor Board Review a promising treatment for cancer?Yes, Genomic Tumor Board Review is a promising treatment for cancer. It helps doctors make better decisions by using detailed genetic information about a patient's tumor. This approach can lead to more personalized and effective treatment plans, improving patient care.235610
What safety data is available for the Genomic Tumor Board Review for Cancer?The provided research does not directly address safety data for the Genomic Tumor Board Review or related interventions. The studies focus on the establishment, perceptions, and utility of genomic tumor boards and testing, but do not specifically mention safety outcomes or data.127910
Eligibility Criteria
This trial is for adults with stage III or IV solid tumors that are recurrent, relapsed, refractory, metastatic, or newly diagnosed and advanced. Participants must be under the care of a study-enrolled physician and have genomic tumor tests ordered but not yet received results. They should not be on hospice care and must consent to participate.Treatment Details
The trial examines if an educationally enhanced genomic tumor board (EGTB) can increase genome-informed treatment in patients with serious solid tumors. It compares usual review methods of genomic test results against those reviewed by a GTB—a team experienced in interpreting genetic changes—to improve treatment decisions.
2Treatment groups
Experimental Treatment
Active Control
Group I: Arm 2 (EGTB)Experimental Treatment6 Interventions
Patients and physicians receive the EGTB intervention. This is comprised of 2 components: the structured GTB and the supporting education. Physicians submit cases for discussion to the GTB within 2 weeks of GTT results. The GTB sessions are held weekly and conducted virtually over a video-conferencing platform. Each case presentation is 10 to 15 minutes long, and 4 to 6 cases are discussed during each 60 minute GTB session. GTT results and clinical data are presented and expert interpretation of genomic test results is provided to help prioritize potential treatment options and provide a framework for interpretation. Supporting education materials are also available online to participants to support GTT decision making.
Group II: Arm 1 (usual care)Active Control5 Interventions
Participants receive usual care. This consists of physicians ordering GTT for patients and reviewing the results without the GTB being involved.
Find a clinic near you
Research locations nearbySelect from list below to view details:
Saint Joseph Mercy OaklandPontiac, MI
Kapiolani Medical Center for Women and ChildrenHonolulu, HI
University of Kansas Cancer Center-Overland ParkOverland Park, KS
University of Hawaii Cancer CenterHonolulu, HI
More Trial Locations
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Who is running the clinical trial?
Southwest Oncology GroupLead Sponsor
SWOG Cancer Research NetworkLead Sponsor
National Cancer Institute (NCI)Collaborator
References
Breast Cancer Experience of the Molecular Tumor Board at the University of California, San Diego Moores Cancer Center. [2022]Multiplex genomic tests are enabling oncologists to interrogate the DNA of their patients. However, few oncologists are proficient with respect to the implications of complex molecular diagnostics. We initiated a Molecular Tumor Board that focused on individual patients with advanced cancer whose tumors underwent genomic profiling, and here report our experience with breast cancer.
"A rising tide lifts all boats": establishing a multidisciplinary genomic tumor board for breast cancer patients with advanced disease. [2018]Research suggests that multidisciplinary genomic tumor boards (MGTB) can inform cancer patient care, though little is known about factors influencing how MGTBs interpret genomic test results, make recommendations, and perceive the utility of this approach. This study's objective was to observe, describe, and assess the establishment of the Breast Multidisciplinary Genomic Tumor Board, the first MGTB focused on interpreting genomic test results for breast cancer patients with advanced disease.
[Management of Cancer Genomic Board and Preparation of Genomic Report]. [2020]The accumulation of gene alteration is the major pathogenicity of any types of cancer. The concept of precision cancer medicine is therefore the individualized treatment based on the driver gene alteration in each case. The cancer gene profiling (CGP) test, so called gene panel test, will be the major clinical examination to identify the driver gene alteration usually using the FFPE tissue from the surgically resected pathological archives, and government insurance system will cover the examination fee for limited number of cancer patients since 2019 in Japan. Although genetic profiling of tumors is a potentially powerful tool to predict drug sensitivity and resistance, its routine use has been limited because physicians are often unfamiliar with interpretation and incorporation of the information into practice. We established a molecular tumor board (MTB)and clinical tumor board(CTB)system to interpret individual patients' tumor genetic profiles and provide treatment recommendations upon the molecular report.
Multicenter Comparison of Molecular Tumor Boards in The Netherlands: Definition, Composition, Methods, and Targeted Therapy Recommendations. [2021]Molecular tumor boards (MTBs) provide rational, genomics-driven, patient-tailored treatment recommendations. Worldwide, MTBs differ in terms of scope, composition, methods, and recommendations. This study aimed to assess differences in methods and agreement in treatment recommendations among MTBs from tertiary cancer referral centers in The Netherlands.
Establishment of a Molecular Tumor Board (MTB) and Uptake of Recommendations in a Community Setting. [2020]In the precision medicine era, molecular testing in advanced cancer is foundational to patient management. Molecular tumor boards (MTBs) can be effective in processing comprehensive genomic profiling (CGP) results and providing expert recommendations. We assessed an MTB and its role in a community setting. This retrospective analysis included patients with MTB recommendations at a community-based oncology practice January 2015 to December 2018; exclusions were death within 60 days of the MTB and/or no metastatic disease. Potentially actionable genomic alterations from CGP (immunohistochemistry, in-situ hybridization, next-generation sequencing) were reviewed bi-weekly by MTB practice experts, pathologists, genetic counselors, and other support staff, and clinical care recommendations were provided. Subsequent chart reviews determined implementation rates of recommendations. In 613 patients, the most common cancers were lung (23%), breast (19%), and colorectal (17%); others included ovarian, endometrial, bladder, and melanoma. Patients received 837 actionable recommendations: standard therapy (37%), clinical trial (31%), germline testing and genetic counseling (17%), off-label therapy (10%), subspecialty multidisciplinary tumor board review (2%), and advice for classifying tumor of unknown origin (2%). Of these recommendations, 36% to 78% were followed by the treating physician. For clinical trial recommendations (n = 262), 13% of patients enrolled in a clinical trial. The median time between CPG result availability and MTB presentation was 12 days. A community oncology-based comprehensive and high-throughput MTB provided useful clinical guidance in various treatment domains within an acceptable timeframe for patients with cancer in a large community setting.
Clinical Outcomes of Molecular Tumor Boards: A Systematic Review. [2022]We conducted this systematic review to evaluate the clinical outcomes associated with molecular tumor board (MTB) review in patients with cancer.
Community oncologists' perceptions and utilization of large-panel genomic tumor testing. [2023]Large-panel genomic tumor testing (GTT) is an emerging technology with great promise but uncertain clinical value. Previous research has documented variability in academic oncologists' perceptions and use of GTT, but little is known about community oncologists' perceptions of GTT and how perceptions relate to clinicians' intentions to use GTT.
Impact of Molecular Tumor Board on the Clinical Management of Patients With Cancer. [2022]Multidisciplinary molecular tumor boards (MTBs) help in interpreting complex genomic data generated by molecular tumor profiling and improve patients' access to targeted therapies. The purpose of this study was to assess the impact of our institution's MTB on the clinical management of patients with cancer.
Patient Understanding of Tumor Genomic Testing: A Quality Improvement Effort. [2023]Tumor genomic testing (TGT) has become increasingly adopted as part of standard cancer care for many cancers. Despite national guidelines around patient education before TGT, available evidence suggests that most patients' understanding of genomics remains limited, particularly lower-income and minority patients, and most patients are not informed regarding potential incidental germline findings.
Concordance Between Recommendations From Multidisciplinary Molecular Tumor Boards and Central Consensus for Cancer Treatment in Japan. [2023]Quality assurance of molecular tumor boards (MTBs) is crucial in cancer genome medicine.