• The increasing number and complexity of biomarkers that guide the selection of new therapies against cancer fragments knowledge on the biology of the disease and hinders the implementation of precision medicine.
• A new digital platform combines different cutting-edge bioinformatics methods with access to multiple databases to interpret the clinical relevance of the molecular alterations observed in the tumour of each patient.
• This new tool is described in a recent article published in Nature Medicine. The tool was used to analyse more than 500 tumours and match patients more effectively with ongoing clinical trials testing novel drugs.

Today, the paper by Tamborero, Dienstmann et al “Support systems to guide clinical decision-making in precision oncology: The Cancer Core Europe Molecular Tumor Board Portal” has been published in Nature Medicine. This work describes the use of a new precision cancer medicine technology to inform the use of individualised treatments in clinical trials, guided by the genomics profile of the tumours. The portal has been developed at Karolinska Institutet and SciLifeLab together with clinical researchers from seven European comprehensive cancer centres who are part of the Cancer Core Europe Consortium, and has currently analysed more than 500 patients’ samples. “With this tool, we seek to support clinicians in an increasingly complex decision-making environment that requires the use of complex databases and computer programs that are not easy to use” explains Dr Rodrigo Dienstmann, principal investigator of Vall d’Hebron Oncology Data Science Group. As the number of molecular biomarkers grows, the use of leading-edge technologies becomes more necessary to facilitate the interpretation of genomic data and the sharing of information, and support treatment planning. Aware of this challenge, Cancer Core Europe developed the Molecular Tumor Board website, described in the article published by Dr Dienstmann and Dr Tamborero. This tool is an assisted clinical decision-making platform that combines a variety of state-of-the-art bioinformatics methods to determine the biological relevance of genetic variants and their clinical actionability.

A COLLABORATIVE TOOL

The Molecular Tumor Board website is currently used by a collaborative network composed of seven European cancer centres, Cancer Core Europe. The website analysed more than 500 patients included in the Basket of Baskets trial (NCT03767075), a several-arm trial that involves patients whose tumours have been categorised based on their genomic characteristics and are unresponsive to standard therapies. “The website automates data interpretation, which prevents errors associated with manual processing and allows systematic analysis based on a set of clinical criteria developed by experts” explains Dr David Tamborero, the leading scientist of the project. “The use of this platform also avoids delays in the delivery of results, which is critical for patients whose condition may deteriorate rapidly”.

The tool provides a platform for the secure sharing of results through personalised reports that contain comprehensive molecular information of the tumour of each patient. These reports are interactive data-rich documents that are discussed weekly in virtual meetings, where the representatives of the multidisciplinary teams of each Cancer Core Europe centre define the most appropriate clinical actions. “From the perspective of oncologists, this system has changed the way we work. This website provides access to the most current knowledge on the tumour mutations relevant to each patient and offers the opportunity to discuss cases with experts from the seven centres in a truly collaborative manner” says Dr Dienstmann.

RAPID LEARNING CURVE

Another advantage of this new tool is that it has a very rapid learning curve. The system yields comprehensive structured results through an interface for oncologists, who must make decisions based on solid information. On a general basis, only a few minutes are devoted to discuss each case, which is essential to being able to escalate the use of data to a large number of patients.

An open-access version of the tool, aimed at non-Cancer Core Europe researchers, has been developed and is available at https://mtbp.org. “In our opinion, the use of this website in the clinical setting is crucial to accelerating the translation of research findings into routine practice. Our objective is to create a digital oncology platform that helps perform a reliable evaluation of new biomarkers and further improve the selection of personalised treatments and the development of clinical trials” concludes Dr Dienstmann.