Tumor Boards Improve Outcomes

The Stanford Cancer Institute (SCI) has over a dozen traditional tumor boards dedicated to tackling different tumor types, including breast, head and neck, thyroid, and gynecologic cancers. The board's primary objective is to identify the most effective cancer treatment and care strategy for each patient. A tumor board consists of a group of medical experts that meet on a regular basis to examine cancer cases and share knowledge with each other. Tumor board meetings can include doctors such as oncologists, pathologists, and surgeons. Depending on the cases being reviewed, additional experts, such as gynecologists, plastic surgeons, urologists, nurse specialists, and social workers, may also participate. Collaboration among various healthcare professionals helps to facilitate the creation of a comprehensive treatment plan.

SCI's Molecular Tumor Board is a program that uses the molecular characteristics of individual tumors to identify novel drugs that could assist patients with advanced cancers that have resisted traditional treatments. The board regularly convenes to brainstorm treatment options for cancer cases referred by physicians inside and outside Stanford.

“By profiling tumors in an individual way, we hope to leverage the amazing advances in genomics and DNA sequencing technologies to better personalize cancer treatments and improve outcomes,” states SCI leader James Ford, MD, professor of medicine and director of the director of Stanford’s Clinical Cancer Genomics Program and the Molecular Tumor Board.

Traditional cancer care categorizes cases based on tissue type and stage of cancer, including whether it has spread to other areas of the body and the patient’s clinical symptoms. Conversely, Stanford’s Molecular Tumor Board comprises experts who examine tumors intractable to treatment and, at the genetic level, identify what causes them to grow. The board includes a diverse range of professionals, including oncologists, pathologists, cancer geneticists, genetic counselors, informatics experts, medical fellows, and residents. The molecular tumor board represents an understanding that cancers often share mutations in key genes that regulate cell growth or signaling pathways. They comb through a maze of data, including any mutations in a tumor’s DNA sequence that existing drugs could target, as well as review a patient’s treatment history to determine eligibility for clinical trials or off-label treatments. 

While the primary objective of tumor boards is to guide treatment decisions and expedite the delivery of the most promising treatment for individual patients, the information generated from this process can also drive progress in precision medicine for larger patient populations. 

“Great challenges in the coming years will include how to rationally combine targeted therapies in a genomically driven way to be more successful and more predictably effective,” states Ford. “In addition, incorporating molecular profiling in diagnosing and managing early-stage cancers and using more sophisticated approaches to profiling tumors and biomarkers will provide better effective care broadly and benefit more people.”

January 2024 by Sarah Pelta
Image: MK Riney