Streamlined digital systems are crucial to better address the challenges brought by precision oncology and accelerate the use of emerging biomarkers wrote in the Nature Cancer a group of investigators who developed a Molecular Tumour Board Portal under the umbrella of Cancer Core Europe. The portal provides a unified legal, scientific and technological platform to share and harness next-generation sequencing data across the connected centres. This academic clinical decision support system creates a unified framework to interpret sequencing results across the seven comprehensive cancer centres. The use of information-rich patient reports with interactive content facilitates collaborative discussion of complex cases during virtual molecular tumour board meetings.
Automating the interpretation and reporting of sequencing results decrease the need for time-consuming manual procedures that are prone to errors. Adoption of an expert-agreed process to systematically link tumour molecular profiles with clinical actions promotes consistent decision-making and structured data captured across the connected centres. The portal creates the infrastructure to systematically gather the molecular and clinical information in a biorepository of data, which supports the discovery of new biomarkers and insights for future trial designs.
The portal is integrated in the Cancer Core Europe clinical workflows and provides a single platform to distribute the results and support shared discussions. This is an unprecedented effort for codeveloping new anticancer therapies and biomarkers under a harmonised infrastructure in Europe. In their article, the authors described their approach and discussed the results of using the Molecular Tumour Board Portal in a consecutive cohort of 500 advanced solid tumours evaluated from January 2019 to January 2021 in the context of the Basket of Baskets study, an ongoing Cancer Core Europe multibasket phase II clinical study that is matching molecular biomarkers with immunotherapies and targeted drugs. They described functional and clinical interpretation of cancer variants along the portal technology.
The authors wrote that deploying the Molecular Tumour Board Portal across the Cancer Core Europe network raised multiple challenges, such as ensuring the interoperability with the information technology systems of each connected centre, automating the retrieval of clinical, pathological and sequencing data provided by different facilities, developing user-friendly interfaces for distinct user types, such as medical practitioners, project managers and data analysts, coordinating the efforts to agree on variant interpretation criteria and actionability prioritisation, and creating the associated resources, such as a database with up-to-date information of the clinical studies open for recruitment across the network. These tasks require expertise from domains such as medical software regulation, cybersecurity and front-end development, which is not easily available in the academic setting and creates needs for collaboration with industry partners.
At the moment, the Molecular Tumour Board Portal system used by the Cancer Core Europe initiatives supports the interpretation of genomics data (mutations, copy-number alterations, structural variants and mutational signatures) and has recently incorporated gene expression analysis. In the context of ongoing efforts to implement new clinical study designs, the authors are currently working on the incorporation of emerging tumour profiling technologies such as proteomics, ex vivo drug screening and digital pathology.
The authors have also created an open website that provides access to a lightweight version of the Molecular Tumour Board Portal analytical framework. This public resource is intended for research purposes and only supports a general interpretation of gene variants that may be of interest for investigators outside this network.
Tamborero D, Dienstmann R, Haj Rachid M, et al. The Molecular Tumor Board Portal supports clinical decisions and automated reporting for precision oncology. Nature Cancer 2022;3:251–261.