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Programmatic Precision Oncology Decision Support for Patients With Gastrointestinal Cancer
Rachel B Keller1, Tali Mazor2, Lynette Sholl3
1Department of Medical Oncology, Dana-Farber Cancer Institute & Harvard Medical School, Boston, MA.
JCO Precision Oncology
|January 12, 2023
Summary
A decision support system, GI TARGET, improved precision oncology care for gastrointestinal cancer patients. It provided molecularly informed recommendations, increasing clinical trial enrollment and targeted therapy use.
Area of Science:
- Oncology
- Genomics
- Clinical Decision Support Systems
Background:
- Precision oncology requires oncologists to navigate complex genomic data and targeted therapies.
- A comprehensive understanding of molecular biomarkers is crucial for optimal cancer care.
Approach:
- Developed and implemented GI TARGET, a precision oncology decision support system at Dana-Farber Cancer Institute.
- A multidisciplinary team reviewed tumor molecular profiling for GI tumors, providing molecularly informed clinical recommendations.
- Utilized MatchMiner for clinical trial matching and suggested targeted therapies (on- or off-label).
Key Points:
- Reviewed genomic data for 506 GI cancer patients, providing recommendations to 19 medical oncologists.
- Recommended precision medicine clinical trials for 80% of patients, resulting in 24 enrollments.
- Recommended targeted therapies for 6% (on-label) and 25% (off-label) of patients, and additional testing for 42%.
Conclusions:
- Integrating precision medicine via a multidisciplinary molecular tumor board is scalable and sustainable.
- Precision oncology recommendations have clinical utility for patients with cancer.
- Decision support systems enhance the application of precision medicine in routine cancer care.
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