A decalogue of Molecular Tumor Board (MTB) recommendations from the CAN.HEAL Consortium.

Introduction: The CAN.HEAL consortium, comprising 47 cancer centers and academic institutions across 17 EU countries, has developed a set of recommendations for Molecular Tumor Boards (MTBs) to address the lack of standardized guidelines in personalized cancer medicine.\r\n\r\nMethods: Over the past 2 years, through extensive collaboration and seven dedicated online meetings, CAN.HEAL experts developed consensus-based recommendations across 10 critical domains.\r\n\r\nResults: The consortium agreed that MTBs' primary role is to perform molecular and clinical assessments for patients requiring care beyond standard treatment. Core MTB composition should include medical oncologists, molecular biologists, pathologists, and bioinformaticians. Patient eligibility criteria should prioritize performance status, with flexibility for rare cases. Shared informed consent is crucial for sample collection, data use, and research. A two-tiered IT workflow, with minimal and maximal datasets, is recommended, along with a comprehensive decision support tool. These recommendations focus on genomic testing, acknowledging diversity of NGS assays and proposing general guidelines. MTB reports should be concise, with technical details provided in the molecular diagnostic report. Innovative approaches like the Drug Rediscovery Protocol support access to off-label therapies. Harmonized training for MTB members is essential to bridging knowledge gaps in this evolving field. Indicators are needed to assess MTB effectiveness over time. Expanding MTB benefits to underserved populations depends on creating a shared European MTB database.\r\n\r\nConclusion: Standardizing MTB practices represents a key step toward equitable access to personalized medicine and improved cancer care across Europe. Sustainable implementation requires coordinated EU efforts, and dynamic MTBs that continuously refine genomic-driven decisions within real-world contexts.\r\n\r\nKeywords: Cancer genomics; EU4Health; NGS assays; Personalized medicine; Precision oncology.