What Is a Molecular Tumour Board — and Why Should You Want One?

An MTB adds something structurally different from more oncologists: it adds specialists whose whole focus is genomic data. Where a standard team reads your NGS report as part of a broader meeting, an MTB is built around it. The board can identify matches to drugs approved for a different cancer type, or to open clinical trials not widely known outside genomic medicine. If your tumour has no actionable alterations, the board will say so clearly — and that is a useful answer, not a wasted step.

A second opinion from another oncologist gives you a second clinical judgement on the same information your current team has. An MTB gives you a different kind of expertise: molecular pathologists and genomics specialists who spend their time interpreting sequencing data rather than treating patients directly. The two serve different purposes and are not alternatives. If you are uncertain about your diagnosis or overall plan, a second clinical opinion is the right first step. If you have NGS data that needs deep interpretation, an MTB adds the most value.

It is possible, and worth asking about upfront. An MTB may identify a drug approved abroad but not yet cleared through CDSCO in India, or one accessible only through a clinical trial. Some matched drugs are available off-label in India, and your oncologist can discuss whether that is feasible in your case. A responsible MTB recommendation includes an honest appraisal of what is actually accessible — not just what the biology suggests. If cost is a concern, say so clearly: there may be trial access, compassionate use, or a locally available alternative.

The MTB works from your NGS report, and that report requires tumour tissue. If your original biopsy sample has been used up or cannot be located, a repeat biopsy may be needed before the review can begin. In some cases a liquid biopsy — a blood test that detects tumour DNA circulating in the bloodstream — can be used instead, though it does not always give the same depth of information as a tissue sample. Ask your oncologist whether your stored tissue is sufficient before waiting for an MTB slot.

Yes, entirely. An MTB is not yet standard practice across all centres in India, which means access depends partly on whether it is raised in the consultation. Your oncologist may not have offered it because it was not indicated at your current stage, because NGS results were still pending, or simply because the conversation moved in a different direction. You can ask directly: 'My NGS results are back — would a molecular tumour board review add anything for my case?' That is a clinical question, and a reasonable one.

No. The MTB makes a recommendation — it does not prescribe treatment. Your oncologist weighs that recommendation against your full clinical picture: your general fitness, other treatments you have had, your goals, and what is available and affordable for you. There will be cases where the MTB identifies something actionable but your oncologist decides it is not appropriate for your specific situation, and that is a legitimate clinical judgement. The MTB is one important input into the decision, not the final word.