FIG 1.

Incorporation of molecular tumor board (MTB) and virtual molecular tumor board (VMTB) workflows into clinical reporting practices. After a patient consults with a clinician and provides a tumor specimen, the clinical next-generation sequencing (NGS) testing is ordered. The clinical laboratory performs the NGS assay and sequencing and reports genomic variants of clinical relevance. The MTB leverages local expertise and available resources to interpret the clinical significance of genomic data. Because MTBs operate locally, there is often opportunity for adding insight directly from the physician and patient that can help guide and/or prepare clinical recommendations. When local expertise is insufficient to make appropriate clinical recommendations, variants are prioritized and patient data are de-identified before VMTB submission. VMTB members from multiple institutions use their cumulative genomic resources and expertise to evaluate an NGS case and to discuss consensus recommendations for the patient.