Precision Medicine for the Definition of Therapeutic Strategies Patients Affected by Cancer

The installation of the Molecular Tumor Board - Virtual Consultation System was presented yesterday for the therapeutic consultation at the Oncological Pole of Sapienza, with online connection and teleconference of the oncological structures belonging to the Molecular Tumor Board (MTB)

The first online connection on the VCS genomic platform, within the Molecular Tumor Board (MTB) of the Oncological Polo of Sapienza (POS), was presented yesterday, Monday 13 of May in the Rector's multimedia classroom.

The meeting was attended by the rector Eugenio Gaudio, the councilor for health Alessio D'Amato, Paolo Marchetti, head of the Oncological Polo of Sapienza and Nello Martini president of the Research and Health Foundation (ReS).

The meeting officially started the installation of the platform and the online discussion of the first patient (with anonymized data).

The platform was born in a context deeply influenced by new technologies, which are changing clinical research, regulatory decisions and the oncological practice itself: to the histological model, based on a sequence that has as its central focus the analysis of the tumor, in fact, there is alongside a mutational model, which can analyze over 300 gene mutations in a single analysis and supply data also on the Tumor Mutation Burden (TMB), thanks to Next Generation Sequencing (NGS) tests.

This new approach has a strong impact on many scientific, organizational, ethical, privacy and process governance variables, therefore the complexity of management requires the establishment of interdisciplinary groups, Molecular Tumor Board - MTB, in which skills related to subjects as oncological, hematology, molecular biology, pathological anatomy, hospital pharmacies are integrated, as well as experts in genomic repositories and privacy legislation to govern the clinical and decision-making processes of appropriateness, with the aim of identifying the most appropriate therapy for individuals cancer patients and to monitor their evolution to subsequent follow-ups.

To ensure the proper functioning of a MTB and, to support the management of the new mutational model based on MTBs, it is necessary to have adequate platforms, which can be used initially at a local level, subsequently at regional and national level.

In addition to the ability to collect and integrate clinical data and diagnostic images from the information systems available to the Oncology Units, it must be available an IT support that allows information sharing, report consultation and access to videoconferences for online discussion of individual cases by specialists belonging to different structures.

Features of the Virtual Consultation System - (VCS in Italian)

The platform was created by Sapienza University of Rome, the Research and Health Foundation (ReS) and Cineca in the context of the framework agreement for the definition and establishment of an operational model for the evaluation and sustainability of health interventions in oncology, and allows consultancy via web among the deans of the Oncological Pole of Sapienza through the exchange of clinical and genomic data and high quality diagnostic images. The main functionalities of the platform allow integrated online sharing of clinical data, high definition diagnostic images (DICOM slides and images), genomic data, specialized reports and offer support tools (web conference) to facilitate discussion among the different sector specialists and reaching consensus on therapy.

All the tools for the collection, monitoring and analysis of patients' clinical cases are provided in a secure SaaS (Software-as-a-Service) mode, via web, with the creation of a centralized digital archive containing data, images, Therapeutic indications, as well as dashboards for data analysis.

"La Sapienza wanted to commit itself," explains rector Eugenio Gaudio, "as a great European university at the forefront and proactive, for the strengthening and coordination of the oncology network of the POS, one of the largest in Europe for numbers and qualifications. This online platform will allow us to do two things: coordinated research on significant numbers and personalized patient care validated by doctors and researchers, to provide the best possible treatment profiled on each specific case. This will be possible also thanks to the international agreements of Sapienza with the M.D. Anderson Cancer Center in Houston and with Harvard Medical School. An important objective both for the health of our patients and for the evolution of research in the oncological field, which despite having made great strides in the last 40 years, deserves an even more sophisticated, personalized and targeted approach."

"We have finally concretized the commitment made during the inauguration of the Oncology Center of Sapienza in May last year." commented Paolo Marchetti, head of the POS "Today we will in fact have the first demonstration of how a teleconference confrontation not only has the advantage of bringing together more specialized knowledge but also of building a huge database, in which to collect the information of the patients who may be used for studies evaluating the efficacy of drugs or treatment modalities. Last but not least, the fundamental advantage is that the discussion of all the cases will allow a great homogeneity of treatment to all patients, guaranteeing in fact the right to the best possible treatment, regardless of the "gateway" to the health system."

"We are proud to have collaborated in the implementation of the platform," Said David Vannozzi, general director of Cineca (which is the technological partner of the project), "Technological innovation, digitalization of processes and transfer of skills acquired in the context of computational research represent a fundamental aspect of Cineca's institutional mission."