Virtual multi-institutional tumor board: a strategy for personalized diagnoses and management of rare CNS tumors
Authors
James L. Rogers, Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 9030 Old Georgetown Rd, Bethesda, MD, 20892, USA.
Thomas Wall, Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 9030 Old Georgetown Rd, Bethesda, MD, 20892, USA.
Alvina A. Acquaye-Mallory, Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 9030 Old Georgetown Rd, Bethesda, MD, 20892, USA.
Lisa Boris, Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 9030 Old Georgetown Rd, Bethesda, MD, 20892, USA.
Yeonju Kim, Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 9030 Old Georgetown Rd, Bethesda, MD, 20892, USA.
Kenneth Aldape, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 10 Center Dr, Bethesda, MD, 20892, USA.
Martha M. Quezado, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 10 Center Dr, Bethesda, MD, 20892, USA.
John A. Butman, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, 10 Center Dr, Bethesda, MD, 20892, USA.
James G. Smirniotopoulos, Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 9030 Old Georgetown Rd, Bethesda, MD, 20892, USA.
Huma Chaudhry, Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 10 Center Dr, Bethesda, MD, 20892, USA.
Christina I. Tsien, Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 9030 Old Georgetown Rd, Bethesda, MD, 20892, USA.
Prashant Chittiboina, Surgical Neurology Branch,, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Dr, Bethesda, MD, 20892, USA.
Kareem Zaghloul, Surgical Neurology Branch,, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Dr, Bethesda, MD, 20892, USA.
Orwa Aboud, Department of Neurology and Neurological Surgery, UC Davis Comprehensive Cancer Center, 4860 Y Street, Sacramento, CA, 95817, USA.
Nicholas G. Avgeropoulos, Brain and Spine Tumor Program, Orlando Health Cancer Institute, 1400 S. Orange Ave, Orlando, FL, 32806, USA.
Eric C. Burton, Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 9030 Old Georgetown Rd, Bethesda, MD, 20892, USA.
David M. Cachia, Department of Hematology/Oncology, University of Massachusetts, 55 Lake Ave, Worcester, MA, 01655, USA.
Karan S. Dixit, Lou and Jean Malnati Brain Tumor Institute, Northwestern University Feinberg School of Medicine, 675 N St Clair St, Chicago, IL, 60611, USA.
Jan Drappatz, Department of Neurology, University of Pittsburgh Medical Center, 5115 Centre Ave, Pittsburgh, PA, 15232, USA.
Erin M. Dunbar, Piedmont Brain Tumor Center, Piedmont Atlanta Hospital, Atlanta, GA, 2001 Peachtree St30309, USA.
Peter Forsyth, Department of Neuro-Oncology, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA.
Edina Komlodi-Pasztor, Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 9030 Old Georgetown Rd, Bethesda, MD, 20892, USA.
Jacob Mandel, Department of Neurology, Baylor College of Medicine, 7200 Cambridge St, Houston, TX, 77030, USA.
Byram H. Ozer, Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 9030 Old Georgetown Rd, Bethesda, MD, 20892, USA.
Eudocia Q. Lee, Center for Neuro-Oncology, Dana Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA.
Surabhi Ranjan, Department of Neurology, Cleveland Clinic Florida, Weston Hospital, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, US.
Rimas V. Lukas, Lou and Jean Malnati Brain Tumor Institute, Northwestern University Feinberg School of Medicine, 675 N St Clair St, Chicago, IL, 60611, USA.
Margarita Raygada, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 1 Center Dr, Bethesda, MD, 20892, USA.
Michael E. Salacz, Department of Hematology and Medical Oncology, MD Anderson Cancer Center at Cooper, Cooper University Health Care, Two Cooper Plaza, Camden, NJ, 08103, USA.
Matthew A. Smith-Cohn, Neuro-Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 9030 Old Georgetown Rd, Bethesda, MD, 20892, USA.
James Snyder, Hermelin Brain Tumor Center, Henry Ford Cancer Institute, 2800 W Grand Blvd, Detroit, MI, 48202, USA.
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 (diagnosis, therapy); Patient Care Team; Referral and Consultation
Publication Date
4-1-2024
Publication Title
Journal of neuro-oncology
Digital Object Identifier (DOI)
10.1007/s11060-024-04613-6
Recommended Citation
Rogers, James L.; Wall, Thomas; Acquaye-Mallory, Alvina A.; Boris, Lisa; Kim, Yeonju; Aldape, Kenneth; Quezado, Martha M.; Butman, John A.; Smirniotopoulos, James G.; Chaudhry, Huma; Tsien, Christina I.; Chittiboina, Prashant; Zaghloul, Kareem; Aboud, Orwa; Avgeropoulos, Nicholas G.; Burton, Eric C.; Cachia, David M.; Dixit, Karan S.; Drappatz, Jan; Dunbar, Erin M.; Forsyth, Peter; Komlodi-Pasztor, Edina; Mandel, Jacob; Ozer, Byram H.; Lee, Eudocia Q.; Ranjan, Surabhi; Lukas, Rimas V.; Raygada, Margarita; Salacz, Michael E.; Smith-Cohn, Matthew A.; and Snyder, James, "Virtual multi-institutional tumor board: a strategy for personalized diagnoses and management of rare CNS tumors" (2024). Neurology. 1753.
https://scholar.barrowneuro.org/neurology/1753
