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23. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin e. V.

Deutsches Netzwerk Evidenzbasierte Medizin e. V.

01. - 03.09.2022, Lübeck

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Generation of a knowledge base for evidence-based precision oncology in the Molecular Tumor Board of the University Cancer Center Schleswig-Holstein

Meeting Abstract

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  • Stephanie Maike Johanna Fliedner - Universitätsklinikum Schleswig-Holstein, Dpt. of Hematology and Oncology, Deutschland; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland
  • Laura Klinke - Universitätsklinikum Schleswig-Holstein, Dpt. of Hematology and Oncology, Deutschland; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland
  • Paul Tiemann - Universitätsklinikum Schleswig-Holstein, Dpt. of Hematology and Oncology, Deutschland; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland
  • Lorenz Bastian - Universitätsklinikum Schleswig-Holstein, Dpt. of Hematology and Oncology, Deutschland; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland
  • Niklas Gebauer - Universitätsklinikum Schleswig-Holstein, Dpt. of Hematology and Oncology, Deutschland; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland
  • Anke Fähnrich - University of Lübeck, Institute for Experimental Dermatology and Institute for Cardiogenetics, Lübeck, Deutschland; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland
  • Niklas Reimer - University of Lübeck, Institute for Experimental Dermatology and Institute for Cardiogenetics, Lübeck, Deutschland; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland
  • Axel Künstner - University of Lübeck, Institute for Experimental Dermatology and Institute for Cardiogenetics, Lübeck, Deutschland; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland
  • Malte Spielmann - Universitätsklinikum Schleswig-Holstein, Institute of Human Genetics, Deutschland; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland
  • Josef Ingenerf - University of Lübeck, Institute of Medical Informatics, Lübeck, Germany; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland
  • Björn Konukiewitz - Universitätsklinikum Schleswig-Holstein, Institute of Pathology, Deutschland; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland
  • Christoph Röcken - Universitätsklinikum Schleswig-Holstein, Institute of Pathology, Deutschland; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland
  • Sven Perner - Universitätsklinikum Schleswig-Holstein, Institute of Pathology, Deutschland; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland
  • Hauke Busch - University of Lübeck, Institute for Experimental Dermatology and Institute for Cardiogenetics, Lübeck, Deutschland; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland
  • Jutta Kirfel - Universitätsklinikum Schleswig-Holstein, Institute of Pathology, Deutschland; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland
  • Nikolas von Bubnoff - Universitätsklinikum Schleswig-Holstein, Dpt. of Hematology and Oncology, Deutschland; Universitätsklinikum Schleswig-Holstein, Universitäres Cancer Center Schleswig-Holstein, Deutschland

Evidenzbasierte Medizin für eine bedarfsgerechte Gesundheitsversorgung. 23. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin. Lübeck, 01.-03.09.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. Doc22ebmPOS-1_2-03

doi: 10.3205/22ebm075, urn:nbn:de:0183-22ebm0750

Published: August 30, 2022

© 2022 Fliedner et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Background/research question: A Molecular Tumor Board (MTB) is intended to recommend personalized treatment for patients with rare or advanced cancer beyond standard-of-care, using extended molecular and genetic analyses. To generate an evidence-based knowledge base for future recommendations, analyses of implementation rate for recommendations and clinical outcome is required. We report a 3-year MTB single-center experience of the University Cancer Center Schleswig-Holstein (UCCSH).

Methods: This retrospective series includes 282 patients discussed from November 2018 to November 2021. The MTB strategy group implemented standard operation procedures for biobanking, a bioinformatics workflow and guided diagnostic procedures including a set of entity-agnostic markers and graded additional diagnostic tests. We assessed actionability of individual variants based on available preclinical and clinical data and provided treatment recommendations that included standardized levels of evidence.

Results: In 36 months, 484 case discussions were performed for 282 patients (1.71 per patient). The majority of patients had solid tumors relapsed or refractory after standard-of-care treatment. 279 diagnostic recommendations were made (98.9%), which included panel sequencing (104, 37.0%), in situ hybridization (28, 10.0%), whole exome sequencing (91, 32.4%) and RNA sequencing (24, 8.5%). WES and RNA-Seq data were analyzed using a standardized bioinformatics workflow. 196 treatment recommendations were given (69.5%). Collection of follow-up data to evaluate the implementation rate and progression-free survival for each individual patient is ongoing.

Conclusion: Individual molecular biomarker profiling results in a high rate of treatment recommendations in patients beyond standard-of-care treatments. Analyses of implementation rate, response to treatment and survival is ongoing. We aim to implement a standardized, three-tiered diagnostic workup across entities, harmonized evidence levels for recommendations, standardized procedures for reporting and follow-up documentation, establishment of a proteomic diagnostic platform and development of a standardized workflow for integration and interpretation of complex, multilevel datasets, embedded in a cBioPortal-based-platform to support rational treatment recommendations. This initiative is part of the cross-consortium collaboration between the HiGHmed and MICRACUM MI-consortia funded by the BMBF.