The promise and limits of patient-reported outcomes in molecular tumor board-guided care: toward a framework for patient-centered precision oncology

Abstract Patient-reported outcomes (PROs) capture symptoms, functioning, quality of life, treatment burden and priorities directly from patients. Their integration into Molecular Tumor Board (MTB)-guided care remains limited and particularly challenging, as recommendations often involve off-label therapies, sparse evidence and complex benefit-burden trade-offs. In this perspective, we propose a four-domain framework encompassing measurement, data integration, decision support and governance to guide longitudinal monitoring and patient-centered learning.