Clinical utility and implementation of a virtual molecular tumor board in real-world oncology practice

To evaluate a decentralized virtual Molecular Tumor Board (MTB) model in routine oncology practice in Russia.

This retrospective analysis included 53 patients with advanced solid tumors discussed at a virtual MTB (December 2021-February 2025) after comprehensive genomic profiling. The primary endpoint was the rate of molecularly targeted therapy (MTT) recommendations, including biomarker-matched (BMT, ESCAT I-II) and biomarker-informed therapy (BIT, ESCAT III-V). Secondary endpoints included recommendation implementation, actionability, progression-free survival (PFS), and overall survival (OS).

Potentially actionable biomarkers (ESCAT I-IV) were identified in 92,9% of patients. The MTB recommended MTT in 52,8%(28/53), including BMT in 10 (18,9%) and BIT in 18 (33,9%), while standard-of-care treatment was recommended in 25 patients (47,2%). Follow-up was available for 40 patients, among whom implementation of the primary MTB recommendation was observed in 27 cases (67,5%). In the evaluable MTT cohort, disease control rate was 59,3% (95% CI 40,7-75,5%) and objective response rate was 11,1% (95% CI 3,9-27,4%); outcomes were more favorable in the BMT subgroup than in the BIT subgroup. Implementation of MTB recommendations was associated with longer PFS (median 5 vs 2 months; HR 0,36, 95% CI 0,17-0,76; p = 0002) and longer OS (median 8 vs 5 months; HR 0,37, 95% CI 0,17-0,78; p = 0,01) than non-implementation.

Our virtual MTB was feasible in routine practice and provided clinically relevant recommendations, with improved outcomes observed when these recommendations were implemented. However, the benefit appeared greatest in patients with clearly targetable alterations supported by higher levels of evidence, particularly ESCAT I-II.