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. 2018 Apr 6;3(3):e000339.
doi: 10.1136/esmoopen-2018-000339. eCollection 2018.

Relevance of a molecular tumour board (MTB) for patients' enrolment in clinical trials: experience of the Institut Curie

Clémence Basse #  1 , Claire Morel #  1 , Marie Alt  1 , Marie Paule Sablin  1 , Coralie Franck  2 , Gaëlle Pierron  2 , Céline Callens  2 , Samia Melaabi  2 , Julien Masliah-Planchon  2 , Guillaume Bataillon  2 , Sophie Gardrat  2 , Marion Lavigne  2 , Benjamin Bonsang  2 , Pauline Vaflard  1 , Elvire Pons Tostivint  1 , Coraline Dubot  1 , Delphine Loirat  1 , Miguelle Marous  1 , Romain Geiss  1 , Nathalie Clément  3 , Gudrun Schleiermacher  3 , Choumouss Kamoun  4 , Elodie Girard  4 , Maude Ardin  4 , Camille Benoist  2 , Virginie Bernard  2 , Odette Mariani  2 , Roman Rouzier  4   5 , Patricia Tresca  1 , Vincent Servois  6 , Anne Vincent-Salomon  2 , Ivan Bieche  2   7 , Christophe Le Tourneau  1   4   8 , Maud Kamal  1
Affiliations

Relevance of a molecular tumour board (MTB) for patients' enrolment in clinical trials: experience of the Institut Curie

Clémence Basse et al. ESMO Open. .

Abstract

Background: High throughput molecular screening techniques allow the identification of multiple molecular alterations, some of which are actionable and can be targeted by molecularly targeted agents (MTA). We aimed at evaluating the relevance of using this approach in the frame of Institut Curie Molecular Tumor Board (MTB) to guide patients with cancer to clinical trials with MTAs.

Patients and methods: We included all patients presented at Institut Curie MTB from 4 October 2014 to 31 October 2017. The following information was extracted from the chart: decision to perform tumour profiling, types of molecular analyses, samples used, molecular alterations identified and those which are actionable, and inclusion in a clinical trial with matched MTA.

Results: 736 patients were presented at the MTB. Molecular analyses were performed in 442 patients (60%). Techniques used included next-generation sequencing, comparative genomic hybridisation array and/or other techniques including immunohistochemistry in 78%, 51% and 58% of patients, respectively. Analyses were performed on a fresh frozen biopsy in 91 patients (21%), on archival tissue (fixed or frozen) in 326 patients (74%) and on both archival and fresh frozen biopsy in 25 patients (6%). At least one molecular alteration was identified in 280 analysed patients (63%). An actionable molecular alteration was identified in 207 analysed patients (47%). Forty-five analysed patients (10%) were enrolled in a clinical trial with matched MTA and 29 additional patients were oriented and included in a clinical trial based on a molecular alteration identified prior to the MTB analysis. Median time between date of specimen reception and molecular results was 28 days (range: 5-168).

Conclusions: The implementation of an MTB at Institut Curie enabled the inclusion of 10% of patients into a clinical trial with matched therapy.

Keywords: clinical trials; molecular tumour board; targeted therapy; tumour profiling.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart of patients discussed in Institut Curie Molecular Tumor Board (MTB).
Figure 2
Figure 2
Tumour types of patients whose cancers harboured actionable molecular alterations in our series. ACUP, adenocarcinoma with unknown primary. Other: appendix (n=1), vagina (n=1), vulva (n=1), adrenal gland (n=1).
Figure 3
Figure 3
Description of actionable molecular alterations identified. ACUP, adenocarcinoma with unknown primary.
Figure 4
Figure 4
Frequency of molecular alterations per tumour type for KRAS mutations (A), PI3KCA mutations (B), CDKN2A losses (C) (loss=homozygous deletion), PTEN inactivations (D) (loss=homozygous deletion, or heterozygous deletion associated to mutation/variant of unknown significance/loss of expression in immunohistochemistry (IHC), or loss of expression in IHC without any other analysis). ACUP, adenocarcinoma with unknown primary.
See this image and copyright information in PMC

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