The conventional tumor board may soon be a thing of the past.

Tumor boards typically comprise practitioners from multiple backgrounds, who meet to weigh a wide range of options for potential oncology treatments, study gene sequencing and assess patients' suitability for clinical trials.

They're essential parts of the care process. But getting oncologists, pathologists, patient advocates and others together in one place can take time and effort.

Now, using cloud technology, researchers have been able to bring the time it takes to assess a patient's tumor from 14 down to four days. Such virtual meetings have also been shown to double, over four years, the number of cases that could be assessed compared to more traditional approaches.

WHY IT MATTERS
In their exploration of virtual molecular tumor boards, researchers from Georgetown University Medical Center combined past results with genetic data to help automated systems arrive at the best treatment outcomes for pancreatic cancer patients.

The new virtual reviews could enable thousands more patients to have their tumors assessed than current, human-intensive models currently allow, according to the results, published today in the Journal of the American Medical Informatics Association.

The virtual boards were able to make tumor assessments for more than 2,000 clinical trials, more than 1,000 cancer drugs and nearly 200 genetic biomarkers associated with targets known to be amenable to treatment, according to researchers.

One of the biggest benefits of the virtual reviews is that they can lower the barriers to care that some patients experience because of their distance from treatment centers. Researchers noted that while only about 5% of traditional pancreatic cancer patients end up enrolling in clinical trials, 22% who undergo virtual screening end up enrolling in a trial.

THE LARGER TREND
Virtual oncology consults are gaining momentum, with innovations coming from many angles. The Biden Cancer Initiative’s Oncology Clinical Trial Information Commons, for instance, is a shared platform where clinical trial data can be stored and accessed for patient matching and analytics. It enables faster patient selection criteria, trial locations and patient participation requirements, and is intended to be compatible with all parts of the clinical trials ecosystem.

At HIMSS19 earlier this year, Dr. James Weese, vice president of Aurora Cancer Care at Milwaukee-based Advocate Aurora Health, offered his perspective on how to assess the success of a precision medicine program and molecular tumor boards.

Molecular therapy is "currently most effective in advanced disease," he said. The value of a molecular tumor board is that it "provides interpretation, advice and saves time," helping steer treatment toward drugs that work and avoidance of drugs that don’t.

ON THE RECORD
"As cancer diagnoses and treatment become more data driven and complex, a VTMB allows for deep discussions and insight into many aspects of a person's unique cancer profile," said Dr. Michael J. Pishvaian, associate professor in the Department of Gastrointestinal Medical Oncology at the University of Texas, MD Anderson Cancer Center.

"Additionally, while there are just a few immunotherapy-related biomarkers currently known for all types of cancer, VTMBs have tremendous potential, when new biomarkers are discovered, to assist in finding patients the best possible clinical trials for their treatment."

"Our platform is unique in that it integrates patient-specific data with genomic knowledge bases to provide a comprehensive report on potential trial enrollment opportunities," added Subha Madhavan, chief data scientist and director of the Innovation Center for Biomedical Informatics at Georgetown University Medical Center. "While the majority of the cases we examined were in pancreatic cancer, our platform was designed to be applicable to any type of advanced cancer."

Benjamin Harris is a Maine-based freelance writer and former new media producer for HIMSS Media.
Twitter: @BenzoHarris.

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