Abstract 179P
Background
Interpreting next-generation sequencing (NGS) results and directing treatment based on those results can be challenging. Molecular tumor boards (MTBs) can help by establishing collaborative frameworks to deliver patient care plans with the appropriate incorporation of genomic data.
Methods
This retrospective observational study evaluates the impact of MTB on the outcomes of adult patients diagnosed with advanced-stage cancer. Patients were grouped into those who received at least one treatment recommended by MTB or those who did not receive treatment recommended by MTB. Kaplan- Meier analysis was performed for overall survival (OS) and progression-free survival (PFS). Cox proportional hazard model was fit for PFS, OS, and time on treatment (ToT) with multivariate adjusting for age, stage, line of therapy, and primary site of diagnosis.
Results
Of 238 evaluable patients, 138 (58%) received at least one treatment recommended by MTB. Patient characteristics were well balanced between the cohorts except for a statistically significantly higher proportion of lung adenocarcinoma (33% v 14%, p=0.0009) & melanoma (9% v 2%, p=0.030) in the matched cohort and more glioblastoma in the unmatched cohort (8% v 1%, p=0.017) (Table). Median ToT was 4.3 months for patients on matched treatment versus 2.8 months for patients who received therapy of provider's choice (HR 0.58, 95% CI [0.41-0.83], p=0.0027). Median PFS was 9.7 months versus 4.3 months for MTB-matched treatment versus provider's choice of treatment (HR 0.64, 95% CI [0.42-0.97],p=0.035). Median OS was 18.5 months for patients on MTB-recommended therapy versus 9.1 months for patients who received therapy of provider's choice (HR 0.64, 95% CI [0.43-0.96],p=0.030).
Conclusions
MTB treatment recommendations improved survival outcomes for patients with cancer even after correcting for imbalances between the two cohorts. Our findings show that MTBs in community cancer centers are feasible and valuable in cancer care. Table: 179P
Histology
Matched | Unmatched | |||||||
No. | (%) | No. | (%) | |||||
138 | 100 | |||||||
Lung Adenocarcinoma | 45 | (33%) | 14 | (14%) | ||||
Colorectal Adenocarcinoma | 10 | (7%) | 14 | (14%) | ||||
Breast Carcinoma | 8 | (6%) | 12 | (12%) | ||||
Melanoma | 12 | (9%) | 2 | (2%) | ||||
Lung Squamous Cell Carcinoma | 7 | (5%) | 7 | (7%) | ||||
Prostatic Adenocarcinoma | 5 | (4%) | 6 | (6%) | ||||
Glioblastoma | 2 | (1%) | 8 | (8%) | ||||
Esophagogastric Adenocarcinoma | 5 | (4%) | 5 | (5%) | ||||
Pancreatic Adenocarcinoma | 2 | (1%) | 6 | (6%) | ||||
Cholangiocarcinoma | 6 | (4%) | 1 | (1%) | ||||
Non-cutaneous Squamous Cell Carcinoma | 6 | (4%) | 1 | (1%) | ||||
Lung Small Cell Carcinoma | 2 | (1%) | 4 | (4%) | ||||
Endometrial Carcinoma | 3 | (2%) | 1 | (1%) | ||||
Sarcoma | 1 | (1%) | 3 | (3%) | ||||
Urothelial Carcinoma | 1 | (1%) | 2 | (2%) | ||||
Appendiceal Adenocarcinoma | 2 | (1%) | 1 | (1%) | ||||
Other Histologies | 21 | (15%) | 13 | (13%) |
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Saint Luke's Foundation.
Disclosure
All authors have declared no conflicts of interest.
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