Abstract 5587
Background
While increasing number of diagnostic laboratories perform new generation sequencing on tumor DNA at a rapidly decreasing cost, beyond companion diagnostics, multi-gene panels are still underutilized due to lack of reimbursement and value based technical assessment. Besides financial reasons, prioritizing between diagnostic tests, multiple genetic alterations and multiple on-label or off-label targeted treatment options linked to these alterations can be a major challenge without having a reproducible, standardized and effective information service system in hand that a molecular tumor board could safely rely on. Here, we present an easily clinically adaptable, dynamic treatment decision support program (Protocol), that makes tumor molecular profile-based oncology care feasible and potentially reimbursed by public insurance funds.
Methods
Our Protocol was developed based on 4868 cancer cases with 429 different histology, 2367 genes with 36492 variants. Our program utilizes multidisciplinary molecular tumor board (MTB) supported by Realtime Oncology Treatment CalculatorTM (Calculator) with the idea of integrating molecular and clinical data to provide genomics-driven treatment strategy plan. MTB mobilizes multiple sub-specialties for managing patients and tumor samples. The Calculator under constant upgrade is currently operating based on 24000 rules, 4000+ curated evidence, 101 registered and 618 targeted drugs under development.
Results
This medical procedure (protocol) was endorsed by the Hungarian National Health Insurance Fund based on QUALY gain calculation and value-based technology assessment.
Conclusions
It is crucial to have an established protocol in the community of practice to indicate effective and eliminate ineffective genomics-driven treatments based on molecular profiling. The technology assessment provided evidence that standardized decision support of the molecular tumor board (MTB) to select diagnostic tests and treatments can assure clinical utility and cost effectiveness of multigene testing (NGS).
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
I. Petak: Leadership role, ownership: Oncompass Medicine Hungary Ltd. C. Hegedus: Full / Part-time employment: Oncompass Medicine Hungary Ltd. E. Várkondi: Full / Part-time employment: Oncompass Medicine Hungary Ltd. Z. Farkas: Full / Part-time employment: Oncompass Medicine Hungary Ltd. D. Tihanyi: Full / Part-time employment: Oncompass Medicine Hungary Ltd. R. Dóczi: Full / Part-time employment: Oncompass Medicine Hungary Ltd. D. Mathiasz: Full / Part-time employment: Oncompass Medicine Hungary Ltd. G. Pajkos: Full / Part-time employment: Oncompass Medicine Hungary Ltd. R. Schwab: Advisory / Consultancy, ownership: Oncompass Medicine Hungary Ltd. J. Deri: Full / Part-time employment: Oncompass Medicine Hungary Ltd. All other authors have declared no conflicts of interest.
Resources from the same session
4021 - Prospective pathological experience with research biopsies in the context of clinical trials at Vall d’Hebron Institute of Oncology
Presenter: Paolo Nuciforo
Session: Poster Display session 3
Resources:
Abstract
5603 - Development of a comprehensive next-generation targeted sequencing assay for detection of gene-fusions in solid tumors
Presenter: Vinay Mittal
Session: Poster Display session 3
Resources:
Abstract
4952 - Next-generation sequencing for better treatment strategy of cancer of unknown primary (CUP)
Presenter: Kang Kook Lee
Session: Poster Display session 3
Resources:
Abstract
4590 - Circulating-free DNA analysis from long-term surviving metastatic colorectal cancer patients undergoing surgery for resectable disease.
Presenter: Michele Ghidini
Session: Poster Display session 3
Resources:
Abstract
3696 - Ultra-sensitive detection of circulating tumor DNA identifies patients in high risk of recurrence in early stages melanoma
Presenter: Filip Janku
Session: Poster Display session 3
Resources:
Abstract
4295 - Identification of the founder BRCA1 mutation c.4117G>T (p.Glu1373*) recurring in Abruzzo and Lazio regions of Central Italy and predisposing to breast/ovarian and BRCA1-related cancers
Presenter: Daniela Di Giacomo
Session: Poster Display session 3
Resources:
Abstract
2214 - Enzalutamide (ENZA) and Apalutamide (APA) In vitro chemical reactivity studies and Activity in a Mouse Drug Allergy Model (MDAM)
Presenter: Mausumee Guha
Session: Poster Display session 3
Resources:
Abstract
5044 - Influence of genetic variation in COMT on cisplatin-induced nephrotoxicity in cancer patients.
Presenter: Bram Agema
Session: Poster Display session 3
Resources:
Abstract
3293 - Cardioprotective and anti-inflammatory effects of Empagliflozin during treatment with Doxorubicin: a cellular and preclinical study
Presenter: Vincenzo Quagliariello
Session: Poster Display session 3
Resources:
Abstract
3324 - Breast Cancer Organoids Model Treatment Response of HER2 Targeted Therapy in HER2-mutant Breast Cancer
Presenter: Xuelu Li
Session: Poster Display session 3
Resources:
Abstract