Virtual multi-institutional tumor board: a strategy for personalized diagnoses and management of rare CNS tumors
Recommended Citation
Rogers JL, Wall T, Acquaye-Mallory AA, Boris L, Kim Y, Aldape K, Quezado MM, Butman JA, Smirniotopoulos JG, Chaudhry H, Tsien CI, Chittiboina P, Zaghloul K, Aboud O, Avgeropoulos NG, Burton EC, Cachia DM, Dixit KS, Drappatz J, Dunbar EM, Forsyth P, Komlodi-Pasztor E, Mandel J, Ozer BH, Lee EQ, Ranjan S, Lukas RV, Raygada M, Salacz ME, Smith-Cohn MA, Snyder J, Soldatos A, Theeler BJ, Widemann BC, Camphausen KA, Heiss JD, Armstrong TS, Gilbert MR, and Penas-Prado M. Virtual multi-institutional tumor board: a strategy for personalized diagnoses and management of rare CNS tumors. J Neurooncol 2024; 167(2):349-359.
Document Type
Article
Publication Date
4-1-2024
Publication Title
Journal of neuro-oncology
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.
Medical Subject Headings
Humans; Retrospective Studies; Pandemics; Central Nervous System Neoplasms; Patient Care Team; Referral and Consultation
PubMed ID
38427131
ePublication
ePub ahead of print
Volume
167
Issue
2
First Page
349
Last Page
359