Clinical Impact of Molecular Tumor Board Inclusion on Treatment Outcomes in Neuroendocrine Neoplasms

Barsch M, Gräßel L, Metzger P, von Werder A, Ganz J, Klaas L, Schulz L, Decker A, Dammer A, Wenzel P, Friedrich M, Falkenstein J, Bertemes H, Kuehn J, Miething C, Lörsch AM, Jung J, Illert AL, Kasajima A, Dorusch Y, Dopfer EP, Schultheis AM, Lassmann S, Pavel ME, Werner M, Boerries M, Duyster J, Schmid RM, Mogler C, Pfarr N, Becker H, Thimme R, Quante M, Lange S (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Acta Cytologica Karger

DOI: 10.1159/000552650

Abstract

Introduction: Neuroendocrine neoplasms (NENs) are rare and biologically heterogeneous tumors with limited evidence-based systemic treatment options, particularly in advanced disease stages. Molecular Tumor Boards (MTBs) offer an interdisciplinary framework for interpreting genomic alterations and identifying personalized treatment strategies. Methods: We conducted a retrospective two-center analysis of patients with NENs discussed at the MTBs of the University Medical Center Freiburg and the Technical University of Munich between 2019 and 2024. Clinical characteristics, molecular profiling results, MTB-based therapy recommendations, treatment implementation, and outcomes were evaluated. Overall survival (OS) was analyzed using a predefined 6-month landmark approach to account for immortal time bias. Treatment efficacy was further assessed using progression-free survival (PFS) and PFS2/PFS1 ratio. Results: A total of 87 patients were discussed at both MTBs, 74 of whom underwent molecular profiling. Actionable therapy recommendations were issued for 58 patients, and 20 patients ultimately received MTB-guided therapy. Molecular alterations frequently involved DNA damage repair pathways, immune-related biomarkers, and signaling cascades relevant to targeted therapy. 6-month landmark OS analysis demonstrated significantly improved OS for patients receiving MTB-guided therapy. At the individual level, 8 of 20 treated patients achieved a PFS2/PFS1 ratio >1.3. Conclusion: Molecular-guided precision oncology can provide clinically meaningful benefit for selected patients with NENs, despite limited overall implementation rates. Earlier integration of molecular profiling may increase the feasibility and impact of personalized treatment approaches in these rare tumor entities.

Authors with CRIS profile

Marianne Ellen Pavel Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology

Involved external institutions

Universitätsklinikum Freiburg DE Germany (DE) Technische Universität München (TUM) DE Germany (DE) Universitätsklinikum Göttingen DE Germany (DE)

How to cite

APA:

Barsch, M., Gräßel, L., Metzger, P., von Werder, A., Ganz, J., Klaas, L.,... Lange, S. (2026). Clinical Impact of Molecular Tumor Board Inclusion on Treatment Outcomes in Neuroendocrine Neoplasms. Acta Cytologica. https://doi.org/10.1159/000552650

MLA:

Barsch, Maryam, et al. "Clinical Impact of Molecular Tumor Board Inclusion on Treatment Outcomes in Neuroendocrine Neoplasms." Acta Cytologica (2026).

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