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. 2024 Mar:10:e2300330.
doi: 10.1200/GO.23.00330.

Discordance in Recommendation Between Next-Generation Sequencing Test Reports and Molecular Tumor Boards in India

Aju Mathew  1 , Sissmol Davis  2 , Jeffrey Mathew Boby  3 , Anu R I  4 , Moushumi Suryavanshi  5 , Shaheenah S Dawood  4 , Pankaj Kumar Panda  5 , Shona Milon Nag  6 , Arunangshu Das  7 , Nitesh Rohatgi  8 , Sanjay Popat  9 , Riyaz N H Shah  10 , Cherian Thampy  11 , Aparna Raj Parikh  12 , Siddhartha Yadav  13 , Prashant Mehta  5 , Randeep Singh  14 , Deborah Mukherji  15 , Ramila Shilpakar  16 , Sujith Kumar Mullapally  5 , Bhawna Sirohi  17
Affiliations

Discordance in Recommendation Between Next-Generation Sequencing Test Reports and Molecular Tumor Boards in India

Aju Mathew et al. JCO Glob Oncol. 2024 Mar.

Abstract

Purpose: Accurate understanding of the genomic and transcriptomic data provided by next-generation sequencing (NGS) is essential for the effective utilization of precision oncology. Molecular tumor boards (MTBs) aim to translate the complex data in NGS reports into effective clinical interventions. Often, MTB treatment recommendations differ from those in the NGS reports. In this study, we analyze the discordance between these recommendations and the rationales behind the discordances, in a non-high-income setting, with international input to evaluate the necessity of MTB in clinical practice.

Methods: We collated data from MTB that were virtually hosted in Chennai, India. We included patients with malignancies who had NGS reports on solid tissue or liquid biopsies, and excluded those with incomplete data. MTB forms and NGS reports of each clinical case were analyzed and evaluated for recommendation concordance. Concordance was defined as an agreement between the first recommendation in the MTB forms and the therapeutic recommendations suggested in the NGS report. Discordance was the absence of the said agreement. The rationales for discordance were identified and documented.

Results: Seventy MTB reports were analyzed with 49 cases meeting the inclusion criteria. The recommendation discordance was 49% (24 of 49). Discordant recommendations were mainly due to low level of evidence for the drug (75% of cases).

Conclusion: The discordance between MTB and NGS vendor recommendations highlights the clinical utility of MTB. The educational experiences provided by this initiative are an example of how virtual academic collaborations can enhance patient care and provider education across geographic borders.

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Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/go/authors/author-center.

Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments).

Figures

FIG 1
FIG 1
Study profile. Seventy MTBs between April 1, 2021 and December 1, 2021 were evaluated. Forty-nine MTBs were included in the study. Seventeen did not provide any treatment recommendations and hence were excluded. Four were discussions on the basis of NGS reports previously discussed in an MTB that was already included in the study, hence were excluded (duplication MTB). MTBs, molecular tumor boards; NGS, next-generation sequencing.
See this image and copyright information in PMC

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