1. Virtual multi-institutional tumor board: a strategy for personalized diagnoses and management of rare CNS tumors.
- Author
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Rogers, James, Wall, Thomas, Acquaye-Mallory, Alvina, Boris, Lisa, Kim, Yeonju, Aldape, Kenneth, Quezado, Martha, Butman, John, Smirniotopoulos, James, Chaudhry, Huma, Tsien, Christina, Chittiboina, Prashant, Zaghloul, Kareem, Aboud, Orwa, Avgeropoulos, Nicholas, Burton, Eric, Cachia, David, Dixit, Karan, Drappatz, Jan, Dunbar, Erin, Forsyth, Peter, Komlodi-Pasztor, Edina, Mandel, Jacob, Ozer, Byram, Lee, Eudocia, Ranjan, Surabhi, Lukas, Rimas, Raygada, Margarita, Salacz, Michael, Smith-Cohn, Matthew, Snyder, James, Soldatos, Ariane, Theeler, Brett, Widemann, Brigitte, Camphausen, Kevin, Heiss, John, Armstrong, Terri, Gilbert, Mark, and Penas-Prado, Marta
- Subjects
Barriers to healthcare access ,Collaborative practice ,Multidisciplinary tumor boards ,National Cancer Institute-Comprehensive Oncology Network Evaluating Rare CNS Tumors (NCI-CONNECT) ,Rare CNS tumors ,Humans ,Retrospective Studies ,Pandemics ,Central Nervous System Neoplasms ,Patient Care Team ,Referral and Consultation - Abstract
PURPOSE: Multidisciplinary tumor boards (MTBs) integrate clinical, molecular, and radiological information and facilitate coordination of neuro-oncology care. During the COVID-19 pandemic, our MTB transitioned to a virtual and multi-institutional format. We hypothesized that this expansion would allow expert review of challenging neuro-oncology cases and contribute to the care of patients with limited access to specialized centers. METHODS: We retrospectively reviewed records from virtual MTBs held between 04/2020-03/2021. Data collected included measures of potential clinical impact, including referrals to observational or therapeutic studies, referrals for specialized neuropathology analysis, and whether molecular findings led to a change in diagnosis and/or guided management suggestions. RESULTS: During 25 meetings, 32 presenters discussed 44 cases. Approximately half (n = 20; 48%) involved a rare central nervous system (CNS) tumor. In 21% (n = 9) the diagnosis was changed or refined based on molecular profiling obtained at the NIH and in 36% (n = 15) molecular findings guided management. Clinical trial suggestions were offered to 31% (n = 13), enrollment in the observational NCI Natural History Study to 21% (n = 9), neuropathology review and molecular testing at the NIH to 17% (n = 7), and all received management suggestions. CONCLUSION: Virtual multi-institutional MTBs enable remote expert review of CNS tumors. We propose them as a strategy to facilitate expert opinions from specialized centers, especially for rare CNS tumors, helping mitigate geographic barriers to patient care and serving as a pre-screening tool for studies. Advanced molecular testing is key to obtaining a precise diagnosis, discovering potentially actionable targets, and guiding management.
- Published
- 2024