Molecular Tumor Boards: A consensus statement from the International Association for the Study of Lung Cancer

Mihaela Aldea; Julia K Rotow; Maria Arcila; Matthew Hatton; Lynette Sholl; Christian Rolfo; Marco Tagliamento; Teodora Radonic; Kurt A Schalper; Vivek Subbiah; Umberto Malapelle; Anja C Roden; Rami Manochakian; Ming-Sound Tsao; Helena Linardou; Rina Hui; Silvia Novello; Alastair Greystoke; Anjali Saqi; Sylvie Lantuejoul; David M Hwang; Kelly Nevins; Murry Wynes; Saiama Waqar; Yuchen Han; Yasushi Yatabe; Wei-Chin Chang; Takuo Hayashi; Tae-Jung Kim; Paul Hofman; Fabio Tavora; Fred R Hirsch; Valeria Denninghoff; Natasha B Leighl; Alexander Drilon; Wendy A Cooper; Sanja Dacic; Pranshu Mohindra; Nick Pavlakis; Fernando Lopez-Rios

doi:10.1016/j.jtho.2025.07.009

Molecular Tumor Boards: A consensus statement from the International Association for the Study of Lung Cancer

J Thorac Oncol. 2025 Jul 7:S1556-0864(25)00831-7. doi: 10.1016/j.jtho.2025.07.009. Online ahead of print.

Authors

Mihaela Aldea¹, Julia K Rotow², Maria Arcila³, Matthew Hatton⁴, Lynette Sholl⁵, Christian Rolfo⁶, Marco Tagliamento⁷, Teodora Radonic⁸, Kurt A Schalper⁹, Vivek Subbiah¹⁰, Umberto Malapelle¹¹, Anja C Roden¹², Rami Manochakian¹³, Ming-Sound Tsao¹⁴, Helena Linardou¹⁵, Rina Hui¹⁶, Silvia Novello¹⁷, Alastair Greystoke¹⁸, Anjali Saqi¹⁹, Sylvie Lantuejoul²⁰, David M Hwang²¹, Kelly Nevins²², Murry Wynes²², Saiama Waqar²³, Yuchen Han²⁴, Yasushi Yatabe²⁵, Wei-Chin Chang²⁶, Takuo Hayashi²⁷, Tae-Jung Kim²⁸, Paul Hofman²⁹, Fabio Tavora³⁰, Fred R Hirsch³¹, Valeria Denninghoff³², Natasha B Leighl³³, Alexander Drilon³⁴, Wendy A Cooper³⁵, Sanja Dacic³⁶, Pranshu Mohindra³⁷, Nick Pavlakis³⁸, Fernando Lopez-Rios³⁹

Affiliations

¹ Department of Medical Oncology, Thoracic and Precision Medicine Group, Gustave Roussy, Villejuif, France; Paris-Saclay University, Paris, France; Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA. Electronic address: mihaela.aldea@gustaveroussy.fr.
² Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.
³ Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
⁴ Department of Clinical Oncology, Weston Park Hospital, Sheffield, United Kingdom.
⁵ Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁶ Department of Medical Oncology, Early Clinical Trials, The Arthur G. James Comprehensive Cancer Center, Ohio State University, Columbus, OH, USA.
⁷ Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genoa, Genova, Italy.
⁸ Department of Pathology, Amsterdam University Medical Center, Free University Amsterdam, Amsterdam, The Netherlands.
⁹ Department of Pathology and Medicine, Yale School of Medicine, New Haven, CT, USA.
¹⁰ Department of Early-Phase Drug Development, Sarah Cannon Research Institute, Nashville, TN, USA.
¹¹ Department of Public Health, University of Naples Federico II, Naples, Italy.
¹² Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
¹³ Division of Hematology/Oncology, Mayo Clinic, Florida, FL, USA.
¹⁴ Department of Pathology, University Health Network and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
¹⁵ Oncology Department and Clinical Trials Center, Metropolitan Hospital, Athens, Greece.
¹⁶ Centre of Cancer Medicine, HKU Med, University of Hong Kong, China; University of Sydney, Australia.
¹⁷ University of Torino, Department of Oncology, San Luigi Hospital, Orbassano, Italy.
¹⁸ Institute of Clinical and Translational Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
¹⁹ Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA.
²⁰ Department of Molecular Pathology, Centre Léon Bérard, CRCL INSERM U1052-CNRS5286, Université Grenoble Alpes, La Tronche, France.
²¹ Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
²² International Association for the Study of Lung Cancer, Denver, Colorado.
²³ Division of Oncology, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
²⁴ Department of Pathology, Shanghai Chest Hospital, Jiaotong University, Shanghai, China.
²⁵ Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan.
²⁶ Department of Pathology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Pathology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
²⁷ Department of Human Pathology, Juntendo University Faculty of Medicine, Tokyo, Japan.
²⁸ Department of Hospital Pathology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea.
²⁹ IHU RespirERA, Hôpital Pasteur, Université Côte d'Azur, Nice, France.
³⁰ Argos Laboratory, Federal University of Ceara, Fortaleza, Brazil.
³¹ Center for Thoracic Oncology, The Tisch Cancer Institute, Icahn School of Medicine, Mount Sinai Health System, New York, NY, USA.
³² Molecular-Clinical Laboratory, University of Buenos Aires-National Council for Scientific and Technical Research (CONICET), Buenos Aires, Argentina.
³³ Princess Margaret Cancer Centre, Department of Medicine, University of Toronto, IHPME, Dalla Lana School of Public Health, Toronto, Canada.
³⁴ Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
³⁵ Royal Prince Alfred Hospital, NSW Health Pathology, Camperdown, NSW, Australia.
³⁶ Department of Pathology, Yale School of Medicine, New Haven, CT, USA.
³⁷ Department of Radiation Oncology, University Hospitals, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.
³⁸ Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Department of Medical Oncology, Royal North Shore Hospital, St Leonards, NSW, Australia; The Thoracic Oncology Group of Australasia, Thornbury, Vic, Australia.
³⁹ Pathology Department, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Research Institute Hospital 12 de Octubre (imas12), CIBERONC, Madrid, Spain.

PMID: 40633839
DOI: 10.1016/j.jtho.2025.07.009

Abstract

Context: Molecular Tumor Boards (MTBs) are multidisciplinary meetings of specialists dedicated to analyzing biomarker test results to provide personalized treatment recommendations. However, global disparities in the successful implementation of MTBs exist, driven by unequal access to molecular diagnostics and supportive multidimensional expertise.

Objective: To establish recommendations for MTB implementation, outline practical frameworks for their operation, and address disparities in expertise and resources between new and established MTBs.

Design: A modified Delphi method involved 37 international experts in three survey rounds and online meetings, with consensus defined as ≥75% agreement.

Results: The panel identified a molecular biologist or pathologist with expertise in molecular diagnostics and tumor-specific medical oncologists as indispensable MTB members. Case selection should reflect institutional expertise and volume, with newer MTBs reviewing less selected cases to gain experience. Regular meetings are advised to avoid delays beyond 14 days from result availability to discussion. Reporting should be standardized to include clinicopathologic data (tumor characteristics, treatment history), biomarker findings (testing results, sample details), and recommendations (treatment, retesting, genetic counseling). Treatment options should be ranked by the level of evidence for actionability and may include options not available locally. Performance evaluation should consider changes in patient management based on MTB input and matched therapy rates.

Conclusions: These MTB consensus recommendations are applicable across tumor types, despite being developed by lung cancer and molecular specialists and initiated by the International Association for the Study of Lung Cancer (IASLC). They provide a structured framework for MTB implementation, report standardization, case selection, and quality assessment, aiming to standardize practice and address gaps in expertise for personalized cancer care.

Keywords: ESCAT; OncoKB; artificial intelligence; biomarker; molecular tumor board; next-generation sequencing.

Publication types

Review