Virtual Multidisciplinary Tumor Boards: A Narrative Review Focused on Lung Cancer

Gebbia, Vittorio; Guarini, Aurelia; Piazza, Dario; Bertani, Alessandro; Spada, Massimiliano; Verderame, Francesco; Sergi, Concetta; Potenza, Enrico; Fazio, Ivan; Blasi, Livio; Sala, Alba La; Mortillaro, Gianluca; Roz, Elena; Marchese, Roberto; Chiarenza, Maurizio; Parra, Héctor Soto; Valerio, Maria Rosaria; Agneta, Giuseppe; Amato, C; Lipari, Helga; Baldari, Sergio; Ferraú, Francesco; Grazia, Alfio Di; Mancuso, Gianfranco; Rizzo, Sérgio; Firenze, Alberto

doi:10.1007/s41030-021-00163-8

Cited by 27 publications

(26 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As one option with some similarities to AccessHope, Meyer et al 10 describe their experience with an asynchronous patient-initiated second opinion service (Best Doctors) covering all aspects of medicine that included 588 patients with hematology or oncology diagnoses, with opinions in this subset estimated to have moderate or major clinical impact in 38% of cases. Another option that provides a multidisciplinary approach is virtual tumor boards or case conferences, which have been pursued for testicular cancer, 11 sarcoma, 12 and lung cancer, 13 with success in improving care while overcoming geographic barriers.…”

Section: Discussionmentioning

confidence: 99%

Novel Program Offering Remote, Asynchronous Subspecialist Input in Thoracic Oncology: Early Experience and Insights Gained During the COVID-19 Pandemic

West

Tan

Barzi

et al. 2022

JCO Oncology Practice

View full text Add to dashboard Cite

PURPOSE: AccessHope is a program developed initially by City of Hope to provide remote subspecialist input on cancer care for patients as a supplemental benefit for specific payers or employers. The leading platform for this work has been an asynchronous model of review of medical records followed by a detailed assessment of past and current management along with discussion of potential future options in a report sent to the local oncologist. This summary describes an early period of development and growth of this service, focusing on cases of lung cancer, particularly during the COVID-19 pandemic. METHODS: Cases were primarily identified by a trigger list of cancer diagnoses that included non–small-cell lung cancer and small-cell lung cancer. After medical records were obtained, a summary narrative was provided to a thoracic oncology specialist who wrote a case review sent to the local physician, followed by a direct discussion with the recipient. We focused on feasibility as measured by case volumes, the rates of concordance between the subspecialist reviewer with the local team, and cost savings from recommended changes, using descriptive statistics. RESULTS: From April 2019 to November 2020, 110 cases were reviewed: 55% male, median age 62.5 years (range, 33-92 years); 82% non–small-cell lung cancer (12% stage I or II, 16% stage III, and 57% stage IV), and 17% small-cell lung cancer (4% limited and 14% extensive). Median turnaround time for report send-out was 5.0 days. The review agreed with local management in 79 (72%) cases and disagreed in 31 (28%) cases; notably, specific additional recommendations were associated with evidence-based anticipated improvements in efficacy in 76 cases (69%) and improvement in potential for cure in 14 cases (13%). Recommendations leading to cost savings were identified in 14 cases (13%), translating to a projected cost savings of $19,062 (USD) per patient for the entire cohort of patient cases reviewed. CONCLUSION: We demonstrate the feasibility of completing a rapid turnaround of cases of lung cancer either patient-initiated for review or prospectively triggered by diagnosis and stage. This program of asynchronous second opinions identified evidence-based management changes affecting current treatment in 28% and potential improvements to improve care in 92% of patients, along with cost savings realized by eliminating low-value interventions.

show abstract

Section: Discussionmentioning

confidence: 99%

Novel Program Offering Remote, Asynchronous Subspecialist Input in Thoracic Oncology: Early Experience and Insights Gained During the COVID-19 Pandemic

West

Tan

Barzi

et al. 2022

JCO Oncology Practice

View full text Add to dashboard Cite

show abstract

“…Tumor boards represent an ideal platform for data driven peer discussion, both as a means to establish best practice for common cancers, but also as a venue for the multi-disciplinary discussion of complex cases in the context of existing resource limitations ( 9 ). The incorporation of peer partners in virtual MDTs from Western academic centers provides an important avenue for sharing new knowledge as well as identifying areas of need for diagnostic investment in the LMIC ( 31 , 32 ). In addition, such platform provide the opportunity for peer discussion and knowledge transfer that ultimately making the optimal therapeutic choice for the patient.…”

Section: Multidisciplinary Tumor Boards and Specialty Clinicsmentioning

confidence: 99%

Promoting Best Practice in Cancer Care in Sub Saharan Africa

Sharma

Sayed²,

Saleh³

2022

Front. Med.

View full text Add to dashboard Cite

Promoting best practice in the management of a cancer patient is rooted in the application of new knowledge derived through various sources including population science, laboratory advances, and translational research. Ultimately, the impact of these advances depends on their application at the patient's bedside. A close collaboration between the oncologist and the pathologist is critical in underwriting progress in the management of the cancer patient. Recent advancements have shown that more granular characteristics of the tumor and the microenvironment are defining determinants when it comes to disease course and overall outcome. Whereas, histologic features and basic immunohistochemical characterization were previously adequate to define the tumor and establish treatment recommendation, the growing capability of the pathologist to provide molecular characterization of the tumor and its microenvironment, as well as, the availability of novel therapeutic agents have revolutionized cancer treatment paradigms and improved patient-outcomes and survival. While such capacity and capability appear readily available in most developed high-income countries (HIC), it will take a concerted and collaborative effort of all stakeholders to pave the way in the same stride in the low and middle-income countries (LMIC), which bear a disproportionate burden of human illness and cancers. Patients in the LMIC present with disease at advanced stage and often display characteristics unlike those encountered in the developed world. To keep stride and avoid the disenfranchisement of patients in the LMIC will require greater participation of LMIC patients on the global clinical trial platform, and a more equitable and affordable sharing of diagnostic and therapeutic capabilities between the developed and developing world. Key to the success of this progress and improvement of patient outcomes in the developing world is the close collaboration between the oncologist and the pathologist in this new era of precision and personalized medicine.

show abstract

“…On the other hand, the molecular tumor board (MTB), which is composed of experts in various fields such as clinical oncology and genetic medicine, discusses the results of genetic mutation analysis; however, it is a complex, time-consuming, and labor-intensive process [ 21 – 23 ]. With the growing expectations for precision medicine and the need to make MTBs more efficient and effective, several MTBs have been reported that utilize a virtual environment [ 24 – 26 ]. The expectation and burden on MTB members are predicted to increase in the future, and the introduction of artificial intelligence (AI) and the latest information and communication technology (ICT) to improve the efficiency and automation of MTB is important when establishing a precision medicine system.…”

Section: Introductionmentioning

confidence: 99%

Introducing AI to the molecular tumor board: one direction toward the establishment of precision medicine using large-scale cancer clinical and biological information

et al. 2022

View full text Add to dashboard Cite

Since U.S. President Barack Obama announced the Precision Medicine Initiative in his New Year’s State of the Union address in 2015, the establishment of a precision medicine system has been emphasized worldwide, particularly in the field of oncology. With the advent of next-generation sequencers specifically, genome analysis technology has made remarkable progress, and there are active efforts to apply genome information to diagnosis and treatment. Generally, in the process of feeding back the results of next-generation sequencing analysis to patients, a molecular tumor board (MTB), consisting of experts in clinical oncology, genetic medicine, etc., is established to discuss the results. On the other hand, an MTB currently involves a large amount of work, with humans searching through vast databases and literature, selecting the best drug candidates, and manually confirming the status of available clinical trials. In addition, as personalized medicine advances, the burden on MTB members is expected to increase in the future. Under these circumstances, introducing cutting-edge artificial intelligence (AI) technology and information and communication technology to MTBs while reducing the burden on MTB members and building a platform that enables more accurate and personalized medical care would be of great benefit to patients. In this review, we introduced the latest status of elemental technologies that have potential for AI utilization in MTB, and discussed issues that may arise in the future as we progress with AI implementation.

show abstract

Virtual Multidisciplinary Tumor Boards: A Narrative Review Focused on Lung Cancer

Cited by 27 publications

References 47 publications

Novel Program Offering Remote, Asynchronous Subspecialist Input in Thoracic Oncology: Early Experience and Insights Gained During the COVID-19 Pandemic

Novel Program Offering Remote, Asynchronous Subspecialist Input in Thoracic Oncology: Early Experience and Insights Gained During the COVID-19 Pandemic

Promoting Best Practice in Cancer Care in Sub Saharan Africa

Introducing AI to the molecular tumor board: one direction toward the establishment of precision medicine using large-scale cancer clinical and biological information

Contact Info

Product

Resources

About