Impact of Molecular Tumor Board on Clinical Outcomes in Patients with Refractory Solid Tumor: a Real-World Study.

Introduction: Providing precise oncologic treatment for patients with refractory solid tumor is still an unmet need in clinical practice. This study aimed to assess whether treatments recommended by a molecular tumor board (MTB) can improve clinical outcomes in patients with refractory solid tumors.

Methods: We screened all patients with refractory solid tumor during the period from 2017 to 2022 at the authors' center. The patients with actionable molecular alterations (mainly included druggable tier 2 genetic variant identified using next-generation sequencing [NGS]) were presented to MTB. We compared the overall survival (OS) and progression-free survival (PFS) between the patients treated with a matched therapy recommended by MTB and those who did not receive the MTB-recommended therapy. Patients with no actionable molecular alterations served as an additional control.

Results: A total of 338 patients with refractory solid tumor were screened. Among the 305 patients for whom NGS testing was conducted, 217 patients available for survival outcomes were included in the final analysis. A total of 129 patients had at least one actionable molecular alteration and were presented to MTB; 82 received the MTB-recommended therapy, while the remaining 47 did not. Those who received the recommended therapy had significantly longer median OS (17.7 vs. 4.4 months; HR 0.31, 95% CI 0.14-0.66; P < 0.001) and median PFS (7.0 vs. 2.3 months, HR 0.32, 95% CI 0.16-0.65; P < 0.001).

Conclusion: MTB improves oncologic prognosis in patients with refractory solid tumor, and matching MTB-recommended therapy is an independent factor for OS and PFS.