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

Publication date: Mar 01, 2024

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. 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. 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. 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.

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Concepts Keywords
Nervous Collaborative practice
Oncology Multidisciplinary tumor boards
Presenters Rare CNS tumors

Semantics

Type Source Name
disease MESH tumor
disease MESH COVID-19 pandemic
disease IDO history
disease MESH rhabdoid tumor
disease MESH choroid plexus tumors
disease MESH gliomas
disease MESH ependymoma
disease MESH gliomatosis cerebri
disease MESH coma
disease MESH sarcomas
disease MESH medulloblastoma
disease MESH meningioma
drug DRUGBANK Pirenzepine
disease MESH complications
disease MESH Brain Tumor
disease VO document
disease MESH Astrocytoma
disease MESH Glioblastoma
pathway KEGG Glioma
disease MESH Ganglioglioma
drug DRUGBANK Vorinostat
disease MESH neuroendocrine tumor
disease MESH Primitive neuroepithelial tumor
drug DRUGBANK Myricetin
disease MESH Hemangioblastoma
disease MESH Craniopharyngioma
disease MESH Hodgkin’s lymphoma
disease MESH uncertainty
disease IDO entity
disease MESH Avian Reticuloendotheliosis
disease VO organization
disease IDO site
disease VO effective
disease VO biweekly
drug DRUGBANK Trestolone
disease VO efficiency
disease MESH colorectal cancer
pathway KEGG Colorectal cancer
disease MESH Esophageal Cancer
disease MESH lung cancer
disease MESH pancreatic diseases
disease VO PepA
disease VO report
disease MESH Central Nervous System Tumors
disease MESH Oligodendroglioma
disease IDO quality
drug DRUGBANK Coenzyme M
drug DRUGBANK Etodolac
disease VO USA

Original Article

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