2 December 2020

Guidelines ready for paradigm shift in approach to cancer care

It will soon be distributed to the twenty-seven IRCCS members of Alleanza Contro il Cancro (the National Oncology Network founded by the Ministry of Health) and to the main stakeholders of Italian health, the volume containing the guidelines for the establishment of the Molecular Tumor Board (MTB).

Organisms designed to evaluate and interpret the outcome of complex molecular tests, aimed at identification, in patients’ tumours or in liquid biopsies, molecular alterations of various kinds that allow to predict vulnerability to molecular target therapies or immunotherapies.

An interpretation, that of MTB, aimed at recommending therapies outside the standards but already approved for other indications or clinical development, for patients who have exhausted the standard lines of therapy for their disease.

MTB are organisms designed to evaluate and interpret the outcome of complex molecular tests, aimed at identifying molecular alterations in patients’ tumours or liquid biopsies that predict vulnerability to molecular targeting or immunotherapies.

The need for coding of MTB is inscribed in the Consensus Document on the development and organization of Mutational Oncology in Italy presented at the recent Annual Meeting of the Network. Prepared together with AIOM and signed by Società Italiana di Anatomia Patologica e Citologia Diagnostica, Res – Fondazione Ricerca e Salute, Periplo, Cipomo, Cittadinanzattiva and Fondazione per la Medicina Personalizzata, the document describes the historical paradigm shift in the approach to cancer treatment by introducing a cultural change with significant effects on both the health of patients and the organization of the National Health Service.

«The MTB has the task of addressing the complexity of the profound changes that technological innovation is causing in the approach to oncology patients,»  explains Prof. Ruggero De Maria, president of ACC. Diagnostics and therapy for tumours – he still says – reached a degree of unimaginable complexity a few years ago. Just think, for example, that the interpretation of the omic analyses needs the support of molecular biologists and bioinformatics. These new figures will contribute, together with other medical specialists, the choice of therapies to be carried out in patients with advanced tumours in the usual meetings of interdisciplinary groups.»

According to Prof. Gennaro Ciliberto, Scientific Director of IRCCS Regina Elena of Rome (ACC meambers), coordinator of the working group that drafted the guidelines, «The expected impact on the survival and quality of life of cancer patients resulting from the use of advanced technologies for the characterization of molecular alterations of tumours and the availability of an increasing number of target therapies and immunotherapies, is enormous.

MTBs have a great responsibility to ensure rigorous, standardized decisions and the generation of reliable data. Alliance Against Cancer has taken up the challenge by generating these guidelines that define the many aspects that characterize the life of an MTB. The auspice – Ciliberto has concluded – is that the MTB of single qualified institutions can work in regional and national nets to generate data of real-world evidence assuring uniformly and without inequalities to the oncological patients on the national territory, high diagnostic and therapeutic standards».

Massimo Boni | Press Office ACC