How a Molecular Tumour Board — Reviews Your Case

MTB review is most useful when your tumour sequencing has revealed an unusual finding, when your cancer has not responded to standard treatment, or when you have a rare cancer type where standard options are limited. ESMO guidance specifically recommends MTB review for patients with advanced disease who have comprehensive genomic profiling results. It is also indicated when sequencing shows a variant that might be targetable but is not part of your cancer's standard treatment pathway. Your oncologist can tell you whether your case falls into one of these groups.

Most boards meet weekly, and the recommendation is usually available within one to two weeks of your case being submitted — provided your sequencing results are already back. If sequencing is still pending, add that turnaround time, which is typically two to four weeks from when the laboratory receives your sample. Ask your oncologist when the case is scheduled for board review and when the written report is expected, so you have a timeline rather than an open wait.

No. The board makes a recommendation, and your treating oncologist brings it to you. The final decision is made with you, taking into account the board's advice alongside your wishes, your general fitness, what other treatments you have had, and what is realistically available. If the board recommends something not available in India or not covered by your insurance, your oncologist will discuss what the realistic options are. You are always part of the final decision.

This is a more common outcome than most people expect, and it is still useful information. It tells your team that the sequencing did not reveal a molecular target that a currently available drug addresses with reasonable evidence. Your oncologist can then pursue the most appropriate standard treatment for your cancer type and stage with more confidence, knowing a targeted approach has been properly evaluated rather than missed. Ask whether any variants of uncertain significance were noted — these may become actionable as new evidence emerges.

Yes. CION coordinates molecular tumour board review for eligible cases. Your oncologist will advise whether your case is suitable based on your tumour type, your sequencing results, and your treatment history. Where comprehensive genomic profiling has not yet been done, your team can guide you on whether it is indicated and where to have it done. Board meetings are typically scheduled weekly, and the written recommendation goes directly to your treating oncologist.

Possibly, and it is worth asking. Sequencing technology has improved substantially, and the evidence base for actionable variants grows steadily — a variant classified as uncertain two years ago may now have a clinical trial or an approved drug behind it. If your cancer has progressed, you are considering a new line of treatment, or new genes have been identified as relevant to your cancer type, ask your oncologist whether repeat sequencing and a fresh board review would add anything. This is a question with a real answer, not a reason for delay.