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Review
. 2024 Apr;33(2):197-216.
doi: 10.1016/j.soc.2023.12.004. Epub 2023 Dec 18.

Evolution of Precision Oncology, Personalized Medicine, and Molecular Tumor Boards

Yu Fujiwara  1 , Shumei Kato  2 , Razelle Kurzrock  3
Affiliations
Review

Evolution of Precision Oncology, Personalized Medicine, and Molecular Tumor Boards

Yu Fujiwara et al. Surg Oncol Clin N Am. 2024 Apr.

Abstract

With multiple molecular targeted therapies available for patients with cancer that correspond to a specific genetic alteration, the selection of the best treatment is essential to ensure therapeutic efficacy. Molecular tumor boards (MTBs) play a key role in this process to deliver personalized medicine to patients with cancer in a multidisciplinary manner. Historically, personalized medicine has been offered to patients with advanced cancer, but the incorporation of molecular targeted therapies and immunotherapy into the perioperative setting requires clinicians to understand the role of the MTB. Evidence is accumulating to support feasibility and survival benefit in patients treated with matched therapy.

Keywords: Histology-agnostic; Personalized medicine; Personalized oncology; Precision medicine; Tumor-agnostic.

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Conflict of interest statement

Disclosure Y. Fujiwara does not have conflicts of interest. S. Kato serves as a consultant for Foundation Medicine. He receives speaker's fees from Roche and the advisory board for Pfizer. He has research funding from ACT Genomics, Sysmex, Japan, Konica Minolta and OmniSeq. R. Kurzrock has received research funding from Boehringer Ingelheim, Germany, Debiopharm, Foundation Medicine, United States, Genentech, United States, Grifols, Spain, Guardant, Incyte, Konica Minolta, MedImmune, United States, Merck Serono, Omniseq, Pfizer, United States, Sequenom, Takeda, Japan, and TopAlliance and from the NCI, United States, as well as consultant and/or speaker fees and/or advisory board/consultant for Actuate Therapeutics, AstraZeneca, Bicara Therapeutics, Inc., Biological Dynamics, Caris, Datar Cancer Genetics, Daiichi, EISAI, EOM Pharmaceuticals, Iylon, LabCorp, Merck, NeoGenomics, Neomed, Pfizer, Precirix, Prosperdtx, Regeneron, Roche, TD2/Volastra, Turning Point Therapeutics, X-Biotech. R. Kurzrock has an equity interest in CureMatch Inc.; serves on the Board of CureMatch and CureMetrix, and is a co-founder of CureMatch. R. Kurzrock is funded in part by 5U01CA180888 to 08 and 5UG1CA233198 to 05.

Figures

Figure 1.
Figure 1.
Concept of precision medicine and role of molecular tumor board. The flowchart to perform precision medicine from specimen sampling, analysis, discussion at molecular tumor board, to treatment suggestions. Created with BioRender.com. Abbreviation: TMB, Tumor mutational burden.
Figure 2.
Figure 2.
Evolution of tumor-agnostic precision oncology in the United States. Each column includes: (1) Agent name, (2) Targeted alterations, and (3) Targeted population. Created with BioRender.com. Abbreviations: BRAF, V-Raf Murine Sarcoma Viral Oncogene Homolog B; dMMR, DNA mismatch repair-deficiency; MEK, Mitogen-activated protein kinase kinase; MSI-H, Microsatellite instability-high; NTRK, Neurotrophic tyrosine receptor kinase; PD-1, Programmed cell death protein 1; RET, Rearranged during transfection.
Figure 3.
Figure 3.
Development of peri-operative precision oncology. Each column includes: (1) Agent name, (2) Targeted alterations, and (3) Targeted population. Created with BioRender.com. Abbreviations: BRAF, V-Raf Murine Sarcoma Viral Oncogene Homolog B; BRCA, BReast CAncer gene; CDK, Cyclin-dependent kinase; EGFR, Epidermal growth factor receptor; HER2, Human epidermal growth factor receptor 2; MEK, Mitogen-activated protein kinase kinase; NSCLC, Non-small cell lung cancer; PARP, Poly-ADP ribose polymerase.
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