UK HealthCare

Markey Molecular Tumor Board Improves Patient Outcomes in Appalachian Kentucky

The Molecular Tumor Board is codirected by Rachel Miller, M.D., and Jill Kolesar, Pharm.D. (photo taken in 2017) Mark Cornelison | UK Photo
The Molecular Tumor Board is co-directed by Rachel Miller, M.D., and Jill Kolesar, Pharm.D. (photo taken in 2017). Mark Cornelison | UK Photo.

LEXINGTON, Ky. (Nov. 2, 2021) — A recent study shows that patients with non-small cell lung cancer reviewed by the University of Kentucky Markey Cancer Center’s Molecular Tumor Board experience improved outcomes, even if they reside in rural Appalachian Kentucky.

Molecular Tumor Boards (MTB) represent a strategy to increase precision medicine use in cancer care by using tumor genomic analysis to help oncologists choose cancer therapies tailored to each patient’s individual needs.

In 2016, UK’s Markey Cancer Center launched a statewide MTB; patients' tumors are tested for mutations using next-generation sequencing (NGS). Impact of the MTB was recently reported in the Journal of Clinical Oncology, Precision Medicine, demonstrating the MTB review process improves overall patient survival for patients newly diagnosed with non-small cell lung cancer. Improved outcomes were associated with MTB reviews, no matter where the patients resided.

The results show that MTBs may help overcome some health disparities for disadvantaged populations, says study author Jill Kolesar, Pharm.D., a professor in UK’s College of Pharmacy who directs Markey’s Precision Medicine Center and co-chairs the MTB.

Lung cancer remains the leading cause of cancer mortality in the U.S. Kentucky leads the nation in both the rate of new cases and deaths because of lung cancer, with the rural and medically underserved Appalachian region carrying the highest cancer burden.

“Our study suggests that this approach to personalized medicine may help reduce health disparities in Appalachian Kentucky by improving access to precision medicine expertise and options after cancer diagnosis,” said Kolesar. "The MTB also provides cancer researchers with information that can lead to the development of new therapeutics and clinical trials that are most relevant to Kentuckians.”

“The Molecular Tumor Board has been a very effective addition to my clinical practice,” said Donald Goodin, M.D., study co-author with Baptist Health Hematology & Oncology in Hardin. “In a rapidly changing landscape of cancer treatments, this provides access to high level opinions regarding options without the need for patients to travel, which is a major barrier to care in our region.”

When a physician requests an MTB review, the NGS report is evaluated by the MTB, an interdisciplinary team with representation from medical oncology, surgical oncology, pathology, radiology, genetic counseling and clinical pharmacology.

Based on the evaluation, the board may recommend three types of potential care: therapies for that patient's cancer type that are approved by the Food and Drug Administration (FDA), FDA-approved therapies in another tumor type and potential clinical trials.

By analyzing the molecular characteristics of cancer tumors on a case-by-case basis, the Molecular Tumor Board also creates a cache of information to direct the development of new therapies and clinical trials that target the types of cancers found at Markey and throughout Kentucky.

The University of Kentucky is increasingly the first choice for students, faculty and staff to pursue their passions and their professional goals. In the last two years, Forbes has named UK among the best employers for diversity, and INSIGHT into Diversity recognized us as a Diversity Champion four years running. UK is ranked among the top 30 campuses in the nation for LGBTQ* inclusion and safety. UK has been judged a “Great College to Work for" three years in a row, and UK is among only 22 universities in the country on Forbes' list of "America's Best Employers."  We are ranked among the top 10 percent of public institutions for research expenditures — a tangible symbol of our breadth and depth as a university focused on discovery that changes lives and communities. And our patients know and appreciate the fact that UK HealthCare has been named the state’s top hospital for five straight years. Accolades and honors are great. But they are more important for what they represent: the idea that creating a community of belonging and commitment to excellence is how we honor our mission to be not simply the University of Kentucky, but the University for Kentucky.