Collaborative, Multidisciplinary Evaluation of Cancer Variants Through Virtual Molecular Tumor Boards Informs Local Clinical Practices

Author:

Rao Shruti1,Pitel Beth2,Wagner Alex H.3,Boca Simina M.1,McCoy Matthew1,King Ian4,Gupta Samir1,Park Ben Ho5,Warner Jeremy L.6,Chen James7,Rogan Peter K.8,Chakravarty Debyani9,Griffith Malachi3,Griffith Obi L.3,Madhavan Subha1

Affiliation:

1. Innovation Center for Biomedical Informatics, Georgetown University Medical Center, Washington, DC

2. Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN

3. McDonnell Genome Institute and Department of Medicine, Washington University School of Medicine, St Louis, MO

4. Laboratory Medicine Program, University Health Network and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada

5. Division of Hematology and Oncology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN

6. Departments of Medicine and Biomedical Informatics, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN

7. Division of Medical Oncology, Department of Biomedical Informatics, The Ohio State University, Columbus, OH

8. Departments of Biochemistry and Oncology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada

9. Kravis Center of Molecular Oncology, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY

Abstract

PURPOSEThe cancer research community is constantly evolving to better understand tumor biology, disease etiology, risk stratification, and pathways to novel treatments. Yet the clinical cancer genomics field has been hindered by redundant efforts to meaningfully collect and interpret disparate data types from multiple high-throughput modalities and integrate into clinical care processes. Bespoke data models, knowledgebases, and one-off customized resources for data analysis often lack adequate governance and quality control needed for these resources to be clinical grade. Many informatics efforts focused on genomic interpretation resources for neoplasms are underway to support data collection, deposition, curation, harmonization, integration, and analytics to support case review and treatment planning.METHODSIn this review, we evaluate and summarize the landscape of available tools, resources, and evidence used in the evaluation of somatic and germline tumor variants within the context of molecular tumor boards.RESULTSMolecular tumor boards (MTBs) are collaborative efforts of multidisciplinary cancer experts equipped with genomic interpretation resources to aid in the delivery of accurate and timely clinical interpretations of complex genomic results for each patient, within an institution or hospital network. Virtual MTBs (VMTBs) provide an online forum for collaborative governance, provenance, and information sharing between experts outside a given hospital network with the potential to enhance MTB discussions. Knowledge sharing in VMTBs and communication with guideline-developing organizations can lead to progress evidenced by data harmonization across resources, crowd-sourced and expert-curated genomic assertions, and a more informed and explainable usage of artificial intelligence.CONCLUSIONAdvances in cancer genomics interpretation aid in better patient and disease classification, more streamlined identification of relevant literature, and a more thorough review of available treatments and predicted patient outcomes.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

General Medicine

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