EPID-04. TUMOR BOARD CONFERENCES IN NEURO-ONCOLOGY: A NATIONWIDE PROVIDER SURVEY

Abstract

Tumor board or multidisciplinary cancer meetings (MCM) are the centerpiece of coordinated specialized neuro-oncology care. Little is known on how these meetings are implemented. Benefits of MCM include coordination, direction for complicated cases, education, and a forum for communication, emerging technology, and clinical trials. This study identifies participation and utilization of neuro-oncology MCM with the goal of improving practice patterns and establishing models for high value care. A cross-sectional descriptive internet survey was used. 85 neuro-oncology centers were identified by the Society for Neuro-Oncology and the American Brain Tumor Association. In addition, NCI designated cancer centers, participants in the Adult Brain Tumor Consortium, or the Brain Tumor Trials Collaborative were asked to participate. 46 centers completed the survey. All centers reviewed primary brain tumors, 93% discussed neoplastic spine disease, 89% metastatic brain lesions, 40% paraneoplastic disease. 98% discuss “challenging cases”, 96% recurrent disease, 82% undiagnosed or pre-surgical cases, 89% utilize radiology review. 100% of MCM included Neuro-Oncologists, Neurosurgery, and Radiation Oncology; Radiologist 98%, Pathologist 96%, and clinical trials 64%. Geneticist, Behavioral Health, and Social Work less than 15%. 76% reviewed Pathology. 80% meet weekly, and 36% include satellite centers. Individual preparation time varied 15-300 minutes. 94% value MCM for clinical decision-making, access to clinical trials 69%, and education 89%. Only 13% document MCM in the medical record. 38% of centers use a molecular tumor board, however many commented with uncertainty as to how this is defined. Neuro-oncology MCMs at leading U.S. institutions show high congruity of core disciplines, cases discussed, and perceived value. There is strong agreement on the role of clinical decision making and education, but the implementation of recommendations varies widely. We identified marked variability in preparation time, documentation, and high uncertainty as to the definition and application of a molecular tumor board.