Expansion of an Academic Molecular Tumor Board to Enhance Access to Biomarker-Driven Trials and Therapies in the Rural Southeastern United States

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This is an article reporting the experience of a large academic institution in implementing a molecular tumor baord in partnership with community oncology providers. A well written manuscript which I would recommend accepting in it's current form. 

While this paper may not present novel findings, its value lies in its ability to consolidate relevant experiences and information that will benefit the field. The authors experience in establishing an academic-community MTB would be of interest to a wider audience.

Author Response

Comments 1: "This is an article reporting the experience of a large academic institution in implementing a molecular tumor baord in partnership with community oncology providers. A well written manuscript which I would recommend accepting in it's current form. 

While this paper may not present novel findings, its value lies in its ability to consolidate relevant experiences and information that will benefit the field. The authors experience in establishing an academic-community MTB would be of interest to a wider audience."

Response 1:  We very much appreciate this review, which requires no revisions.

Reviewer 2 Report

Comments and Suggestions for Authors

The article stated: Targeting tumor-specific molecular alterations benefits cancer treatment, but rural areas often lack access to molecular tumor boards (MTBs). An academic-community partnership aimed to extend MTB expertise to these areas through a centralized molecular registry. Among 151 patients, 58% had actionable biomarkers, 28% were eligible for targeted therapies, and 18% matched clinical trials, but only 3% enrolled. Key barriers to participation included distance (70%), lack of transportation (55%), and limited local trials (50%). The study highlights the need for better access to molecular expertise and addresses ongoing enrollment challenges.

Comments:

1. align the font size in figures be the same

Author Response

Comments 1: align the font size in figures be the same

Response 1: We thank the reviewer for this comment. We have modified the font size of each figure legend to be the same.

Reviewer 3 Report

Comments and Suggestions for Authors

The idea of MTB programme is very valuable and although the number of patients included is low I think that it deserves the publication. Availability of MTB for patients outside of big clinical centers as well as for underprivileged populations sometimes means the difference between life an death. 
Abstract and introduction are clearly written.

Figure 2 should be bigger because it is not leggable as is right now. 
Results are clearly written and discussion points to major findings of the study. Conclusion "the expansion of academic MTBs  in conjunction with interventions addressing cancer-related costs, literacy, and transportation, this approach has the potential to increase rates of precision oncology delivery to underserved communities and mitigate rural versus urban disparities in cancer outcomes." is a dream of all healthcare systems in the world and this initiative of MTBs is a good step towards this dream becoming a reality.

Author Response

Comments 1: Figure 2 should be bigger because it is not leggable as is right now. 

Response 1: We thank the review for this suggestion and agree that the original figure was too small. We have. increased the size in this revision and will ensure that the figure size is adjusted for maximum legibility in the final proofs.