Abstract
Abstract There is increased use of targeted therapies for children with Central Nervous System (CNS) tumours both at presentation and at relapse. Eighteen months ago, a dedicated CNS targeted therapy clinic was set up at The Great North Children’s Hospital in Newcastle upon Tyne. Referrals are accepted from all major centres in the north of the UK. Within our monthly clinic, five targeted therapies have been used so far including Selumetinib and Tovorafenib with an average of eight children per clinic. General practitioners are asked to carry out all blood investigations forty-eight hours prior to clinic. This has been audited and initial analyses show we have successfully reduced the time children spend in hospital from four hours to one hour. Having blood results prior to clinic means treatment can be prescribed and dispensed promptly. Furthermore, obtaining bloods in the community has reduced the workload for our oncology day unit. The side effect profile of targeted therapies differ from those of standard chemotherapy and requires specific expertise from members of the multidisciplinary team. We are able to predict trends in symptoms and manage them successfully and efficiently. We have direct access to the ophthalmology and Neurofibromatosis team at each clinic. We offer skin care management prior to beginning treatment and will refer to the dermatology team for a same day review where needed. Finally, this clinic has enabled us to offer informal peer support for children and their families, which enhances their overall hospital experience. In summary, our Targeted Therapy Clinic, with the invaluable input of many members of the MDT, has improved the quality of care for children being treated on targeted agents. Given these benefits, we are keen to support other Primary Treatment Centres to develop similar clinics, especially with the increased use of targeted treatments across CNS tumours.
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