PO.CL07.01 · 临床研究
采用循证算法对分子肿瘤委员会的治疗建议进行排序，以为癌症患者提供最佳诊疗并改善预后——持续性研究
Ranking therapeutic recommendations of Molecular Tumor Board with an evidence-based algorithm to deliver optimal care and improve outcomes for cancer patients- continuous study
作者与单位 Authors & Affiliations
摘要 Abstract
中文摘要
背景：分子肿瘤委员会（MTB）为精准肿瘤学带来了重大进展，但由于分子学依据、疾病相关性和患者个体化问题，选择最有效的患者特异性治疗策略一直是长期存在的挑战。我们开发了一种算法，融合分子学和临床循证标准，对治疗策略进行排序，以为恶性肿瘤患者提供最佳诊疗并改善预后。本部分研究旨在评估我们这一新算法的有效性和准确性。
方法：Avera MTB回顾了2021年6月至2024年12月期间571例癌症患者的现病史和全面基因组分析结果。治疗建议附有排序评分（R，-1至12）。随后评估接受推荐治疗的患者（队列1）与未接受推荐治疗的患者（队列2）的无进展生存期（PFS）和总生存期（OS）。
结果：截至2025年7月31日的数据截止点，中位随访时长为14.1个月。在571例患者中，542例（94.9%）癌症患者可纳入本研究评估，其中286例（52.8%）接受了我们MTB推荐的匹配治疗方案，256例（47.2%）未接受。队列1与队列2患者之间的PFS/OS未观察到显著差异。在队列1中，接受早线（≤第3线，n=236）治疗的患者与接受后线（>第3线，n=46）治疗的患者相比，PFS（中位PFS 8.8对4个月，p<0.0001）和OS（中位OS 24.5对13.7个月，p=0.0058）更长。在队列1患者中，R≥10的患者（n=218，8.6/23.9个月）中位PFS/OS长于R<10的患者（n=68，4.9/13.1个月），p=0.036/0.0009；接受标准治疗且R≥9的患者（n=230，22.2个月）的OS长于R<9的患者（n=27，13.1个月），p=0.0053，而PFS未发现显著差异。接受超说明书用药且R≥7的患者（n=10，35.6/未达到 个月）的PFS/OS长于R<7的患者（n=5，3.5/10个月），p=0.0095/0.012；然而，在接受临床试验治疗的患者中，PFS/OS未观察到显著差异。
结论：我们这一基于分子学和临床循证的新算法可用于支持肿瘤科医生的决策，以采用最具临床适宜性和有效性的治疗方案使患者获益。后续计划开展进一步的验证研究，并基于该算法开发用户友好的计算排序平台。
查看英文原文 English abstract
Background: The Molecular Tumor Board (MTB) has brought about significant advancements in precision oncology, but there is a long-standing challenge in selecting the most effective patient-specific therapeutic strategy due to the molecular rationale, disease relevance, and patient-specific issues. We have developed an algorithm that incorporates both molecular and clinical evidence-based criteria to rank therapeutic strategies to deliver optimal care and improve outcomes in patients with malignancy. This part of our studies was to evaluate the effectiveness and accuracy of our novel algorithm.
Methods: History of present illness and comprehensive genomic profiling results of 571 cancer patients were reviewed by Avera MTB from June 2021 to December 2024. Therapeutic recommendations were provided with the Ranking Score (R, -1 to 12). The progression free survival (PFS) and overall survival (OS) of the patients that received recommended treatments (Cohort 1) or not (Cohort 2) were then assessed.
Results: The median duration of follow-up was 14.1 months by the data cut-off on July 31, 2025. Of the 571 patients, 542 (94.9%) patients with cancer were evaluable in this study, including 286 (52.8%) that received matched therapeutic plans recommended by our MTB, and 256 (47.2%) did not. No significant differences in PFS/OS were observed between patients in Cohort 1 and in Cohort 2. In Cohort1, patients who received early line (≤ line 3, n=236) therapies had longer PFS (median PFS 8.8 vs 4 months, p <0.0001) and OS (median OS 24.5 vs 13.7 months, p =0.0058) when compared with those that received later lines (> line 3, n=46) of treatment. Among patients in Cohort 1, the median PFS/OS for patients with R≥10 (n=218, 8.6/23.9 months) were longer than patients with R<10 (n=68, 4.9/13.1 months), p =0.036/ 0.0009; the OS of patients that received Standard of Care treatments with R≥9 (n=230, 22.2 months) were longer than R<9 (n=27, 13.1 months), p =0.0053, whereas no significant difference was found in PFS. The PFS/OS of patients who received Off-Label treatments with R≥7 (n=10, 35.6/not reached months) were longer than R<7 (n=5, 3.5/10 months), p =0.0095/0.012; however, no significant differences in PFS/OS were observed among patients treated on Clinical trials.
Conclusion: Our novel molecular and clinical evidence-based algorithm may be used to support oncologists' decision-making to utilize the most clinically appropriate and effective therapeutic options to benefit patients. Further validation studies and development of a user-friendly computational ranking platform based on the algorithm are planned in order.
利益披露 Disclosure
Y. Sun, None..
C. Hattum, None..
T. Meissner, None.