gms | German Medical Science

Introduction: With precision medicine and drugs aiming for specific targets regardless of the entity being on the rise, more and more hospitals are implementing Molecular Tumor Boards (MTB) [1]. Physicians have to overcome new challenges in providing genetics-guided therapy options and gathering information on specific molecular variations. The work processes from a list of identified known mutations to recommended therapy options and their prospects for success is associated with extensive research in public databases focused on genetic variations, pathways and drugs as well as literature databases.

The goal of this study is to provide an overview of tools and knowledge databases, which can be useful for the preparation of MTB.

Methods: Oncologists at the National Center for Tumor Diseases in Heidelberg established a MTB in 2013 [2], [3]. In close collaboration with participating physicians we identified a list of publicly available tools and databases which are utilized in the preparation of the MTB in Heidelberg. This list was complemented by databases we discovered using scientific and non-scientific search engines focusing on providing detailed information about genes, mutations, drugs and treatments in the oncological sector as these information are essential for discussing molecular variations of a specific patient. Our emphasis was on easily available web applications, that do not require installation or integration into a software suite, and can be directly utilized by individual physicians without investment in infrastructure or integration. Thus we excluded tools which required installation. We assessed the tools by gathering their main features and approaches toward accessing knowledge or tooling.

Results: We identified 20 knowledge bases of which eight databases are specialized in genetic information. Proteins, pathways and medication are the focus of two databases respectively. Information about publications is mainly accessed through Pubmed while studies are described in ClinicalTrials.gov. Furthermore, four tools were identified as a useful way to annotate genetic variants. (The full list can be accessed at https://drive.google.com/file/d/1gqDZmrDby5_s2zI_eIIqF3O6EdThWR_M/view?usp=sharing)

Discussion: Even though the declared aim of MTB is to propose therapy options, physicians have to gather information from various databases of which exceedingly few offer immediate information about therapies. However, information are interlinked with each other. Facts about a variation from a genetically specialized database can help to identify preclinical or even clinical data from drugs targeting the affected proteins or other proteins in a modified pathway. More information may be found in publications and in some cases even studies can be discovered in which a patient can be enrolled.

Additionally to the identification of useful databases to answer highly specialized questions other factors like the formulation of these questions within a specific database have a huge influence on the quality of the results. This makes the preparation of MTB a time-consuming and complex task.

We acknowledge that our market evaluation cannot be exhaustive. The analysed databases show only a mere fraction of knowledge, which can be found in the web. However, we were not able to find an official registry or an established list for knowledge bases focused on oncology or the preparation of MTB.

The authors declare that they have no competing interests.

The authors declare that an ethics committee vote is not required.