Introduction
Material and methods
Molecular Tumor Board
Workflow
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Patients suffering from advanced disease with no further “standard of care” therapeutic options.
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Patients presenting with an unusual clinical presentation or disease course for the respective disease or suffering from a rare entity or a rare pathological subtype.
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Patients should qualify for experimental treatment concerning clinical condition and life expectancy.
Diagnostics
Sequencing assays
Follow-up
Results
Patient characteristics
Baseline characteristics (n = 1000) | |
Age | Median: 56 years; range 14–86 years |
Gender | 383 (42.0%) male, 534 (58.0%) female |
Diagnosis (selected); n (%) | |
Breast cancer | 148 (16.2) |
Biliary tract cancer | 56 (6.1) |
Cervical cancer | 15 (1.6) |
Colorectal cancer | 100 (10.9) |
Cancer of unknown primary | 42 (4.6) |
Gastric cancer | 14 (1.5) |
Glioblastoma | 15 (1.6) |
Head and neck cancer | 11 (1.2) |
Melanoma | 15 (1.6) |
Neuroendocrine malignancies | 23 (2.5) |
NSCLC | 61 (6.7) |
Ovarian cancer | 37 (4.0) |
Pancreatic cancer | 71 (7.8) |
Prostate cancer | 10 (1.1) |
Sarcoma | 54 (5.9) |
Thyroid cancer | 46 (5.0) |
Urinary tract cancer | 24 (2.7) |
Outcome
Panel | Total number | Actionable/Recommendation for therapy | Alteration, not druggable | No alteration | Testing not successful |
---|---|---|---|---|---|
In-house | 337 | 122 (36.2%) | 57 (16.9%) | 99 (29.4%) | 59 (17.5%) |
In-house (after application of the comprehensive (OCAv3) and TMB panel) | 434 | 173 (40.0%) | 163 (37.6%) | 61 (14.1%) | 37 (8.5%) |
Commercial | 94 | 51 (54.3%) | 32 (34.0%) | 2 (2.1%) | 9 (9.6%) |
Therapeutic recommendations
Therapeutic recommendation | n | Frequency (%) |
---|---|---|
TKI | 95 | 25.3 |
mTOR inhibitor | 74 | 19.7 |
Immune-checkpoint-inhibitor | 40 | 10.6 |
PARP inhibitor | 34 | 9.0 |
Clinical trial | 32 | 8.5 |
BRAF/MEK inhibition | 27 | 7.2 |
Genetic counselling | 27 | 7.2 |
Monoclonal antibody | 23 | 6.1 |
IDH1/2 inhibitor | 17 | 4.5 |
Additional diagnostics | 14 | 3.8 |
Alpelisib | 10 | 2.7 |
Trametinib/hydroxychloroquine | 10 | 2.7 |
Androgen-receptor blockade | 9 | 2.4 |
CDK4/6 inhibitor | 9 | 2.4 |
Change in management | 3 | 0.8 |
Alteration | n | Frequency (%) |
---|---|---|
TMB LOW | 157 | 61.1 |
KRAS | 97 | 37.8 |
TP53 | 86 | 33.5 |
PIK3CA | 17 | 6.6 |
MYC | 14 | 5.4 |
ARID1A/2 | 10 | 2.8 |
CDKN2A | 10 | 2.8 |
NRAS | 9 | 3.5 |
SMAD 4 | 8 | 3.1 |
APC | 7 | 2.7 |
CTNNB1 | 5 | 2.9 |
BRAF (non V600E) | 3 | 1.2 |
PTEN | 3 | 1.2 |
Tumor mutational burden
TMB | N | % |
---|---|---|
Low* (≤ 5 mutations/Mb) | 157 | 67.38 |
Intermediate* (> 5/ < 20 mutations/Mb) | 65 | 27.90 |
High* (≥ 20/ < 50 mutations/Mb) | 9 | 3.86 |
Very high* (≥ 50 mutations/Mb) | 2 | 0.86 |
< 10 Mutations/Mb | 208 | 89.27 |
≥ 10 Mutations/Mb | 25 | 10.73 |