Clinical outcomes from a multi-institution precision oncology tumor board: The PROMOTE study update.

Abstract

e23355 Background: The role of next generation sequencing to identify unique genetic makeup of a tumor has become monumental in cancer care. The implementation of molecular tumor boards (MTB) provides a multidisciplinary approach to guide individualized treatment options for each patient. Since 2022, the University of Illinois Cancer Center has adapted monthly Precision Oncology Tumor Board (POTB) discussions for this purpose. Since the establishment of the POTB, the program has expanded to include other institutions in the Chicago and surrounding area. We aim to analyze the impact of POTB recommendations on PFS for patients across all types of cancer. Methods: We investigated patients presented at POTB between September 2022 to May 2025 and gathered data through retrospective chart review. Patient demographics including age, sex, race, ethnicity, insurance, cancer type, cancer stage, time from diagnosis, and recommendation category were obtained. We defined PFS1 as the line of therapy prior to initiation of POTB recommended therapy and PFS2 as the POTB recommended therapy started as a subsequent line of therapy. The PFS2/PFS1 ratio was calculated to determine significant clinical benefit from POTB recommendations. Results: A total of 100 patients were included in the analysis and of these, 28 patients received POTB recommendations that led to change in therapy. In our POTB group (n = 28), 82% of patients were older than 64 years of age and 78% of patients were receiving Medicare or Medicaid. The study population comprised patients who were Asian (14%), Black (39%), and White (39%). At presentation, 75% of patients had stage IV disease, with lung cancer being the most common malignancy (36%). About 50% of patients were presented at POTB at >1 year after diagnosis and targeted therapy was recommended in 57% of patients, while immunotherapy in 21% and chemotherapy in 7%. PFS1 was found to be 6.9 months versus 5.2 months for PFS2 with a p-value of 0.5379. The PFS2/PFS1 ratio is 0.75. Conclusions: The advancement of precision oncology has allowed an increase in treatment options for patients with advanced cancers. Our cohort represents a small proportion of patients but supports a trend towards improved PFS in patients when tumor molecular profiling is used to guide care. Qualitatively, MTBs also expand patient care by offering improved access to clinical trials and re-evaluation of precision oncology strategies by the MTB. Our study represents one of the most racially and ethnically diverse groups of patients to be presented in a molecular tumor board cohort. As MTBs continue to be integrated into cancer care, additional data is needed to quantify their clinical impact.