Abstract：
Multidisciplinary tumor boards (MTBs) have become the reference standard of cancer management, founded upon randomized controlled trial (RCT) evidence-based guidelines. The inordinate delays inherent in awaiting formal regulatory agency approvals of novel therapeutic agents, and the rigidities and nongeneralizability of this regimented approach, often deny cancer patients timely access to effective innovative treatment. Reluctance of MTBs to accept theranostic care of patients with advanced neuroendocrine tumors (NETs) and metastatic castrate-resistant prostate cancer resulted in decades of delay in the incorporation of 177Lu-octreotate and 177Lu-prostate-specific membrane antigen (PSMA) into routine clinical oncology practice. Recent developments in immunotherapy and molecular targeted precision therapy, based on N-of-One individual multifactorial genome analyses, have greatly increased the complexity of decision-making. Burgeoning specialist workload and tight time frames now threaten to overwhelm the logistically, and emotionally, demanding MTB system. It is hypothesized that the advent of advanced artificial intelligence technology and Chatbot natural language algorithms will shift the cancer care paradigm from a MTB management model toward a personal physician-patient shared-care partnership for real-world practice of precision individualized holistic oncology.
摘要：
多学科肿瘤委员会（MTB）已成为癌症管理的参考标准，基于随机对照试验（RCT）循证指南。等待新治疗剂的正式监管机构批准所固有的过度延迟，以及这种有组织的方法的刚性和不可推广性，经常拒绝癌症患者及时获得有效的创新治疗。MTB不愿接受晚期神经内分泌肿瘤（NETs）和转移性去势抵抗性前列腺癌患者的治疗，导致177Lu-奥曲酯和177Lu-前列腺特异性膜抗原（PSMA）在常规临床肿瘤学实践中的掺入延迟了数十年。免疫治疗和分子靶向精准治疗的最新进展，基于N-of-One个体多因素基因组分析，大大增加了决策的复杂性。新兴的专家工作量和紧迫的时间框架现在威胁要压倒后勤，情感上，要求MTB系统。据推测，先进的人工智能技术和Chatbot自然语言算法的出现将使癌症护理范式从MTB管理模式转变为个人医患共享护理合作伙伴关系，以实现精确个性化整体肿瘤学的现实实践。
