The first patients have been selected for precision cancer therapy using the Molecular Tumor Board portal, a platform to support clinical decisions based on the genomics profile of the tumors. The Molecular Tumor Board portal is developed by researchers at Karolinska Institutet and SciLifeLab to help clinicians interpret biological cancer data and select the most appropriate treatment for each patient.
Precision medicine largely relies on the ability to interpret the molecular characteristics of the tumors that can be discovered through modern technologies. Vast efforts are currently ongoing to understand the significance of the tumor alterations for the diagnosis, prognosis and therapy selection. However, the knowledge that is continuously generated by the oncology community is scattered across a multitude of resources that follow different data models, which impedes the use of this information in a clinical setting. Moreover, most of the variants that are observed in a tumor are of unknown significance and additional computational tools are required to estimate their relevance.
To address these issues, the Lehtiö lab has developed the Molecular Tumor Board portal, a platform for the annotation and distribution of biological tumor data. The portal employs a variety of state-of-the-art tools to interpret the biological and clinical significance of the tumor alterations, which serve to different clinical needs. Among them, the identification of the treatment that may be better suited to each tumor, including standard-of-care therapies, drugs approved for other cancer types, and therapies being tested in clinical trials.
“The objective of the portal is double. On the one hand, the reports that we generate ensure that the treating clinician can address his/her decisions based on the best interpretation of the data according to present knowledge. On the other, the use of a standardized framework to annotate and collect the data of these tumors will generate a wealth of new information that will serve to better guide these decisions in the patients of the future”, says David Tamborero, leading researcher of the project.
Professor Janne Lehtiö is already planning the next step.
“I see a need and a huge potential to improve future therapy decisions by incorporating other data to complement the genome level data presented today, such as the tumor protein information profiled by mass spectrometry technology”, says Janne Lehtiö.
In recent years, a new era of anti-cancer drugs that exploit specific molecular vulnerabilities of the tumors – the so-called targeted therapies and immunotherapies – have shown remarkable clinical successes. However, many challenges remain in the quest of selecting the most appropriate treatment for each patient disease. At present, the portal provides genomic analyses, but the researchers aim to implement the interpretation of data types such as transcriptomics, proteomics and ex-vivo drug testing results.
The Molecular Tumor Board portal is currently used in a large clinical trial sponsored by Roche and run by the seven leading European oncology centers that forms the Cancer Core Europe. The work is co-funded by the Cancer Society in Stockholm, the Swedish Foundation for Strategic Research and the Swedish Cancer Society.
“The portal has changed how we work. By using the portal we have easy access to the latest data on cancer mutations relevant for each patient and can discuss the cases in weekly meetings with colleagues from all the seven centers. The interpretation of the tumor molecular data guides the allocation of patients unresponsive to standard treatments to the most appropriate clinical trial”, says Jeffrey Yachnin who heads a unit at the Center for Clinical Cancer Research at the Karolinska University Hospital.