Precision Medicine and Multidisciplinary Care are Shaping the Future of Lung Cancer
In the rapidly evolving field of oncology, precision medicine is proving to be a game changer. At the forefront of this movement is cloud-based data systems that streamline the matching of patients to targeted therapies and clinical trials. However, it can be difficult to interpret the complex data and ensure all patients are benefiting.
To help solve these challenges, Moffitt Cancer Center pioneered the creation of meetings comprised of multidisciplinary experts called thoracic molecular tumor boards. There, the experts can utilize cutting edge technology to fuel discussions and revolutionize the way lung cancer patients receive care.
Precision oncology refers to the tailoring of treatment based on the unique genetic makeup of a patient’s tumor. Through advanced techniques such as next generation sequencing (NGS), oncologists can identify specific genetic alterations driving cancer growth. These insights can enable the selection of therapies that target these alterations, often leading to better outcomes and fewer side effects compared to traditional chemotherapy.
“Precision medicine uses genomics, liver and renal function, environmental exposures and other unique patient characteristics to guide therapy decision making. In oncology, this approach, commonly referred to as precision oncology, is critical for identifying the most effective treatments for individual patients,” said J. Kevin Hicks, MD, a precision medicine specialist in the Pathology Department and chair of the thoracic molecular tumor board at Moffitt.
The tumor board is a collaborative effort between the Precision Medicine and Thoracic departments. It meets weekly to review the NGS results of lung cancer patients and identify opportunities for targeted therapy and clinical trials. The board includes a diverse group of experts, including oncologists, pharmacists, clinical trial coordinators, molecular pathologists and anatomical pathologists. This multidisciplinary approach ensures that each patient's case is thoroughly examined, and the best possible treatment options are identified.
“Our molecular tumor board was established to bridge clinical practice gaps and enhance communication between oncologists and clinical trial investigators,” Hicks said. “This board has been instrumental in ensuring that our patients benefit fully from the advances in precision oncology.”
One of the most innovative aspects of this approach is the use of a cloud-based personal medicine data mart that was developed in collaboration with Health Informatics. This secure system ingests discrete genomic data and patient information that is stored in the Moffitt Cancer Analytics Platform, a data platform designed to improve data curation, integration and access. The personal medicine data mart links NGS data to customizable interpretations, which are then entered into the patient’s electronic health record. This process enables real-time review of NGS results and supports the tumor board in making timely and informed decisions about patient care.
The impact of this system is evident. Data presented at the 2024 World Conference on Lung Cancer shows that between July 1, 2023, and Dec. 31, 2023, the thoracic molecular tumor board reviewed 364 cases involving 323 unique patients. Among unique patients, 123 were diagnosed with lung cancer harboring a genomic alteration that could be targeted with a commercially available drug. For patients who hadn’t yet received any treatment, almost all received frontline targeted therapy that is associated with better treatment outcomes when compared to traditional chemotherapy-based regimens. Clinical trial opportunities were also identified for 57% of patients. During the evaluation period, 60 patients were enrolled onto an interventional clinical trial with 45 discussed at the weekly thoracic molecular tumor board meetings.
“Our thoracic molecular tumor board is feasible, allows for real-time review of NGS results, facilitates targeted therapy and trial matching. This approach is dramatically improving outcomes for our patients and setting a new standard for precision oncology,” Hicks said.
