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Updated: Oct 4, 2025
Author Spotlight: Integrating Computational and Experimental Approaches in Precision Oncology
Published on: December 1, 2023
Delivering Precision Oncology in a Community Cancer Program: Results From a Prospective Observational Study
Steven F Powell1, Elie G Dib1, Jonathan S Bleeker1
1Steven F. Powell, Elie G. Dib, Jonathan S. Bleeker, Michael D. Keppen, Miroslaw Mazurczak, Keely M. Hack, Megan L. Landsverk, and Chun-Hung Chan, Sanford Cancer Center; Morgan E. Nelson, Paul A. Thompson, Christie Ellison, and Lora J. Black, Sanford Research, Sioux Falls, SD; Mark M. Gitau, Preston D. Steen, Shelby A. Terstriep, and Anu G. Gaba, Roger Maris Cancer Center, Fargo; John Reynolds, Sanford Cancer Center, Bismarck, ND; James M. Ford, Stanford University School of Medicine, Stanford, CA; Jon H. Chung and Rachel Anhorn, Foundation Medicine, Cambridge, MA.
Introduction:
Precision oncology (PO) is a growing treatment approach in the era of next-generation sequencing (NGS) and matched therapies. Effective delivery of PO in the community has not been extensively studied. Our program developed a virtual molecular tumor board (MTB) strategy to help guide PO care.
Materials And Methods:
Over 18 months, eligible adult patients with advanced, incurable solid tumor malignancies were enrolled in a molecular profiling (MP) study using the Foundation Medicine NGS panel. Results were reviewed through a weekly, videoconferenced MTB conducted across our largely rural integrated health system. Recommendations from the MTB were used to identify actionable alterations (AAs). Feasibility of PO care delivery was assessed as the primary outcome. Secondary outcomes included the frequency of AAs, genomic matched treatments, genomic matched clinical trial enrollment, and clinical outcomes.
Results:
A total of 120 participants with a variety of advanced tumor types were enrolled. Of these, 109 (90.8%) had successful MP. Treatment on the basis of an AA was recommended by the MTB in 58% of patients (63 of 109) who had a successful MP result. For those completing MP, treatments included enrollment in a genomic matched clinical trial (n = 16; 14.6%) and genomic matched treatment with a Food and Drug Administration-approved agent (n = 23; 21.1%). Response and survival data were similar regardless of the matched treatment option chosen.
Conclusion:
A video-conferenced MTB-facilitated NGS testing and treatment delivery system was implemented in our integrated community oncology program. Continued use of this model aims to increase understanding of the impact of PO in this setting.
Insights
A virtual molecular tumor board (MTB) facilitated next-generation sequencing (NGS) testing and treatment delivery for precision oncology (PO) in a community setting. This model shows feasibility for expanding PO care in integrated health systems.
Area of Science:
- Oncology
- Genomics
- Molecular Diagnostics
Background:
- Precision oncology (PO) leverages next-generation sequencing (NGS) and targeted therapies for cancer treatment.
- Effective delivery of PO in community settings remains understudied.
- A virtual molecular tumor board (MTB) strategy was developed to guide PO care.
Purpose of the Study:
- To assess the feasibility of delivering precision oncology care in a community setting.
- To evaluate the impact of a virtual molecular tumor board (MTB) on treatment recommendations.
- To analyze the frequency of actionable alterations and genomic-matched treatments.
Main Methods:
- Adult patients with advanced solid tumors were enrolled in a molecular profiling (MP) study using NGS.
- Results were reviewed weekly via a videoconferenced MTB within an integrated health system.
- Feasibility of PO care delivery was the primary outcome, with secondary outcomes including actionable alterations and treatment enrollment.
Main Results:
- Of 120 participants, 109 (90.8%) had successful MP.
- The MTB recommended treatment based on actionable alterations in 58% of patients with successful MP.
- Genomic-matched treatments included clinical trial enrollment (14.6%) and FDA-approved agents (21.1%).
Conclusions:
- A virtual MTB-facilitated NGS testing and treatment delivery system was successfully implemented in a community oncology program.
- This model demonstrates feasibility for expanding precision oncology in integrated health systems.
- Further research is needed to understand the full impact of PO in this setting.
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