“It’s not just one person advocating.”
From a series of offices inside UK HealthCare’s Markey Cancer Center, there’s a virtual meeting going on. A team of doctors is poring over genetic testing, patient histories, new medications and novel treatments. It’s time-consuming, detail-obsessed work—and it’s work that can double a cancer patient’s chances at survival.
This is the meeting of the Markey Cancer Center Molecular Tumor Board. Every person involved is here for the same reason: to offer cancer patients a level of care that’s personalized on the molecular level, analyzing the genetic characteristics of their tumors on a case-by-case basis. In the process, the Board is also revolutionizing precision oncology—and reshaping the future of cancer care.
The Molecular Tumor Board is an interdisciplinary team of experts in medical oncology, surgical oncology, pathology, radiology, genetic counseling and clinical pharmacology. Using a process called Next-Generation Sequencing (NGS), the Molecular Tumor Board analyzes tumor genotypes and molecular abnormalities, giving patients access to customized cancer therapies.
“Cancer treatment has changed dramatically in the last ten years,” said Dr. Jill Kolesar, who serves as co-director of the Molecular Tumor Board. “The more we learn about the mutations that are driving the cancer, the more drugs can be developed to target those specific mutations. It’s been shown in clinical trials, over and over again, that if you have a mutation and that mutation is targetable—and you receive targeted drug treatment—you do at least twice as well as someone who doesn’t have a targetable mutation.”
Thanks to NGS reporting, the Molecular Tumor Board can examine anywhere from five to 700 genes—an enormous advancement from the days of single-gene testing. “A lot of cancers have dozens of different mutations, which can result in dozens of interventions,” said Dr. Kolesar. More testing and more information gives doctors and patients a better chance at finding an answer.
In addition to analyzing the higher amounts of data provided by the NGS report, the Molecular Tumor Board can offer customized recommendations for physicians, based on the very latest studies and treatments. For those facing a cancer diagnosis, it’s an approach that can make all the difference. Just ask Elizabeth (E) Barr—who is now living proof of the power of precision oncology.
After being diagnosed with ovarian cancer in 2017, E underwent surgery and a grueling schedule of chemotherapy to beat it. But by 2018, her cancer was back and required a new approach. To identify the best path forward, her oncologist sent her case to the Molecular Tumor Board. The Board recommended a novel approach in treating her particular type of cancer, focused on a specific mutation in her tumor. Six months later, E’s scans were cancer-free.
E’s case is just one of many—and the benefits of precision oncology are only becoming clearer. A 2021 study found that Molecular Tumor Board review improved overall survival in non-small-cell lung cancer patients treated at Markey Cancer Center and community practices. In fact, patients without Molecular Tumor Board review had more than eight times higher risk of dying than those who received treatment recommendations from the Board.
As one of only a handful of academic health care institutions in the United States to offer Molecular Tumor Board review to patients statewide, Markey Cancer Center is transforming cancer care throughout the Commonwealth. Through Molecular Tumor Board referrals, community medical oncologists can now provide patients with the best possible targeted therapies—without sending them across the state for treatments.
“The Molecular Tumor Board has been very helpful in getting drugs for people that insurance has denied,” said Dr. Kolesar. “It’s not just one person advocating, it’s a team that’s saying ‘This is the best treatment for the patient.’”
Expanding precision oncology and making the highest quality cancer care more accessible to more people is a primary driver of UK HealthCare’s Molecular Tumor Board—and is something Dr. Kolesar considers to be her personal mission.
“I found myself asking, ‘Why are people in the community not getting access to these great cutting-edge treatments that we’ve developed? Why does it take ten, sometimes 20 years for these treatments to get into the community?’” said Dr. Kolesar. “My goal is for every patient in the community to have the same access that they would if they came to a large academic medical center.”
And through the Markey Cancer Center, which provides Molecular Tumor Board reviews to any patient in Kentucky whose physician requests one, she’s helping to do just that—changing how Kentucky treats cancer, one patient and one molecule at a time.