The Emergence of Virtual Tumor Boards in Neuro-Oncology: Opportunities and Challenges

Abstract

Background Virtual tumor board (VTB) platforms are an important aspect of cancer management. They enable easier access to a multidisciplinary team of experts. To deliver high-quality cancer care, it is necessary to coordinate numerous therapies and providers, share technical knowledge, and maintain open lines of communication among all professionals involved. The VTB is an essential tool in the diagnosis and treatment of brain cancer. For patients with glioma and brain metastases, multidisciplinary tumor board guidelines should guide diagnosis and therapy throughout the course of the illness. VTBs are an emerging resource across various cancer care networks in the United States. Methodology We performed a systematic search of all VTBs incorporating a platform designed for this specific role. We reviewed the records of the Genomet VTB, the Medical University of South Carolina (MUSC) VTB, and Xcures VTB. Summary data examined included the year of launch, demographics, characteristics of cases, average response time, advantages, and how they handle protected health information. Results Overall, 30% of VTBs examined were launched in 2017. All had a Health Insurance Portability and Accountability Act-compliant online environment. On a review of Xcures records, the median age of the female patients was 57 years and the median age of the male patients was 55 years. The data showed that 44% (4.4 out of every 10 patients) with a confirmed treatment chose the VTB integrated option. Overall, 76% of patients in the Xcures registry had primary central nervous system tumors, with at least 556 patients in the tumor registry which included 46% glioblastoma cases (96% primary, 4% secondary). In the MUSC VTB project, 112 thoracic tumor cases and nine neuro-oncology cases were reviewed. The tumor board met weekly, and the average response time was within 24 hours of case review and presentation. The Genomet VTB de-identifies all patient information; this is a virtual platform primarily focused on neuro-oncology cases. Cases involved a median of five specialists most commonly neuro-oncologists, neurosurgeons, radiation oncologists, molecular pathologists, and neuroradiologists. The case review revealed an age range of six months to 84 years (mean age = 44.5 years), with 69.6% males and 30.4% females, 43.5% glioblastomas, 8.7% adenocarcinomas, and 8.7% infratentorial tumors. The average response time observed in all cases was ≤24 hours. Conclusions VTBs allow for quicker expert analysis of cases. This has resulted in an accelerated number of cases reviewed with a shortened communication time. More studies are needed to gain additional insights into user engagement metrics.

Neuroimaging in neuro-oncology: A Comparative Study

“…Overall, the goal of neuro-oncology is to improve outcomes and quality of life for patients with brain and spinal cord tumors, and to advance our understanding of these complex diseases. Another recent advance in neuro-oncology imaging is the use of advanced molecular imaging techniques to characterize tumors at the molecular level [4][5][6]. This includes techniques such as magnetic resonance spectroscopy (MRS) and PET imaging with radiolabeled agents that target specific molecular pathways involved in tumor growth.…”

Fundamentals of Neurology a Psychophysiological Approach

“…In summary, advances in neuro-oncology imaging have led to more accurate detection and characterization of brain tumors, improved surgical planning, and the development of personalized treatment plans. These advances have the potential to improve outcomes for patients with brain tumors and are an important area of ongoing research [5].…”

A new horizon for molecular neuro-oncology in clinical practice

“…Maximal excision of the affected area of brain tissue is desired during neurosurgical resection of brain lesions, but more significantly, there should be no neurological damage as a result. Damage to the cortical regions immediately around a lesion, the white matter at the depths of the lesion, and the brain tissue implicated in the surgical approach can all result in a new deficiency [3,4]. Understanding the anatomical and physiological link between a lesion and the surrounding expressive brain tissue is essential to minimally morbid surgery.…”