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