Virtual multi-institutional tumor board: a strategy for personalized diagnoses and management of rare CNS tumors

期刊论文
出版模式：

开放获取
发表日期：

2024年3月1日

查看全文

James L. Rogers,
Thomas Wall,
Alvina A. Acquaye-Mallory,
Lisa Boris,
Yeonju Kim,
Kenneth Aldape,
Martha M. Quezado,
John A. Butman,
James G. Smirniotopoulos,
Huma Chaudhry,
Christina I. Tsien,
Prashant Chittiboina,
Kareem Zaghloul,
Orwa Aboud,
Nicholas G. Avgeropoulos,
Eric C. Burton,
David M. Cachia,
Karan S. Dixit,
Jan Drappatz,
Erin M. Dunbar,
Peter Forsyth,
Edina Komlodi-Pasztor,
Jacob Mandel,
Byram H. Ozer,
Eudocia Q. Lee,
Surabhi Ranjan,
Rimas V. Lukas,
Margarita Raygada,
Michael E. Salacz,
Matthew A. Smith-Cohn,
James Snyder,
Ariane Soldatos,
Brett J. Theeler,
Brigitte C. Widemann,
Kevin A. Camphausen,
John D. Heiss,
Terri S. Armstrong,
Mark R. Gilbert,
Marta Penas-Prado

摘要

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.