The impact of the multi-disciplinary molecular tumour board and integrative next generation sequencing on clinical outcomes in advanced solid tumours

Aya El Helali; Tai-Chung Lam; Elaine Yee-Ling Ko; David J H Shih; Chun Kau Chan; Charlene H L Wong; Jason W H Wong; Lydia W T Cheung; Johnny K S Lau; Anthony P Y Liu; Ann S Y Chan; Herbert H Loong; Stephen Tak Sum Lam; Godfrey Chi-Fung Chan; Victor H F Lee; Kwok Keung Yuen; Wai-Tong Ng; Anne W M Lee; Edmond S K Ma

doi:10.1016/j.lanwpc.2023.100775

The impact of the multi-disciplinary molecular tumour board and integrative next generation sequencing on clinical outcomes in advanced solid tumours

Lancet Reg Health West Pac. 2023 Apr 28:36:100775. doi: 10.1016/j.lanwpc.2023.100775. eCollection 2023 Jul.

Authors

Aya El Helali^{1

2}, Tai-Chung Lam^{1

2}, Elaine Yee-Ling Ko¹, David J H Shih³, Chun Kau Chan¹, Charlene H L Wong^{1

2}, Jason W H Wong³, Lydia W T Cheung³, Johnny K S Lau^{1

2}, Anthony P Y Liu⁴, Ann S Y Chan⁵, Herbert H Loong⁶, Stephen Tak Sum Lam⁷, Godfrey Chi-Fung Chan⁴, Victor H F Lee^{1

2}, Kwok Keung Yuen⁵, Wai-Tong Ng^{1

2}, Anne W M Lee^{1

2}, Edmond S K Ma⁸

Affiliations

¹ Department of Clinical Oncology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
² Oncology Medical Center, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.
³ School of Biomedical Science, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
⁴ Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong SAR, China.
⁵ Department of Clinical Oncology, Queen Mary Hospital, Hong Kong SAR, China.
⁶ Department of Clinical Oncology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
⁷ Clinical Genetics Service, Hong Kong Sanatorium & Hospital, Hong Kong SAR, China.
⁸ Division of Clinical Pathology & Molecular Pathology, Hong Kong Sanatorium Hospital, Hong Kong SAR, China.

Abstract

Background: The integration of next-generation sequencing (NGS) comprehensive gene profiling (CGP) into clinical practice is playing an increasingly important role in oncology. Therefore, the HKU-HKSH Multi-disciplinary Molecular Tumour Board (MTB) was established to advance precision oncology in Hong Kong. A multicenter retrospective study investigated the feasibility of the HKU-HKSH MTB in determining genome-guided therapy for treatment-refractory solid cancers in Hong Kong.

Methods: Patients who were presented at the HKU-HKSH MTB between August 2018 and June 2022 were included in this study. The primary study endpoints were the proportion of patients who receive MTB-guided therapy based on genomic analysis and overall survival (OS). Secondary endpoints included the proportion of patients with actionable genomic alterations, objective response rate (ORR), and disease control rate (DCR). The Kaplan-Meier method was used in the survival analyses, and hazard ratios were calculated using univariate Cox regression.

Findings: 122 patients were reviewed at the HKU-HKSH MTB, and 63% (n = 77) adopted treatment per the MTB recommendations. These patients achieved a significantly longer median OS than those who did not receive MTB-guided therapy (12.7 months vs. 5.2 months, P = 0.0073). Their ORR and DCR were 29% and 65%, respectively.

Interpretation: Our study demonstrated that among patients with heavily pre-treated advanced solid cancers, MTB-guided treatment could positively impact survival outcomes, thus illustrating the applicability of NGS CGPs in real-world clinical practice.

Funding: The study was supported by the Li Shu Pui Medical Foundation. Dr Aya El Helali was supported by the Li Shu Pui Medical Foundation Fellowship grant from the Li Shu Pui Medical Foundation. Funders had no role in study design, data collection, data analysis, interpretation, or writing of the report.

Keywords: Molecular tumour board; Next-generation sequencing; Precision oncology; Sequence-directed therapy.