Cross-Border Network of European Specialists Provides New Treatment Options For Women with Complex Rare Gynaecological Cancers

A. Bergamini¹, U. Joneborg², G. Marquina³, E. Grassi⁴, E. Wallin², A. Casado Herraez⁵, O. Solheim⁶, C.M. Sassu⁷, C. Lok⁸, M. Bini⁹, P. Pautier¹⁰, F. Kridelka¹¹, J. Sehouli¹², E. Van Nieuwenhuysen¹³, J. Coulter¹⁴, P-A. Bolze¹⁵, C. Lebreton¹⁶, P. Jurgen¹⁷, I.L. Ray-Coquard¹⁸, M.J. Seckl¹⁹ [Text Wrapping Break]¹Gynaecological Oncology, IRCCS Ospedale San Raffaele, Milan, Italy, ²2. Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden, ³Medical Oncology, Hospital Clinico Universitario San Carlos, Madrid, Spain, ⁴1. Department of Gynaecological Oncology, IRCCS Ospedale San Raffaele, Milan, Italy, ⁵Medical Oncology Department, Hospital Clinico Universitario San Carlos, Madrid, Spain, ⁶Sep.of Gynacological Oncology, Oslo University Hospital – The Norwegian Radium Hospital, Oslo, Norway, ⁷Dipartimento Scienze della Salute della Donna, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy, ⁸Gynecologic Oncology, NKI-AVL – Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands, ⁹Dipartimento di Oncologia, Istituto Nazionale dei Tumori di Milano – Fondazione IRCCS, Milan, Italy, ¹⁰Medicine Department, Institut Gustave Roussy, Villejuif, France, ¹¹Chu de Liege, CHU de Liège – Sart Tilman Site, Liège, Belgium, ¹²Gynecology, Charité – Universitaetsmedizin Berlin, Berlin, Germany, ¹³Gynaecological Oncology Department, UZ Leuven – University Hospitals Leuven – Campus Gasthuisberg, Leuven, Belgium, ¹⁴12. Department of Gynaecological Oncology, CUH – Cork University Hospital, Cork, Ireland, ¹⁵Centre Français de Référence des Maladies Trophoblastiques, CICLY – Centre pour l’lnnovation en Cancérologie de Lyon – Université Lyon 1-EA 3738, Oullins, France, ¹⁶Medical Oncology Department, Institute Bergonié – Centre Régional de Lutte Contre le Cancer (CLCC), Bordeaux, France, ¹⁷15. Department of Obstetrics and Gynecology, Catharina Hospital Eindhoven, Eindhoven, Netherlands, ¹⁸Medical Oncology Department, Centre Léon Bérard, Lyon, France, ¹⁹Surgery and Cancer Department, Charing Cross Hospital – Imperial College Healthcare NHS Trust, London, UK 

Background: The European Reference Network for Rare Adult Cancers (EURACAN) G2 domain deals with rare gynaecological cancers. Within this domain, virtual multi-disciplinary tumor boards (MDTs) were implemented to advise on clinical management of complex cases. Here, we present the 6-year activity outcomes. 

Methods: EURACAN G2 MDTs were organized monthly since November 2017 by Karolinska University Hospital, Stockholm. From March 2021 to March 2023, the MDTs were coordinated by Ospedale San Raffaele, Milan and since April 2023 by Hospital Clinico San Carlos, Madrid. A summary of cases was circulated to participants prior to MDTs and recommendations were distributed following each MDT. Background data and outcomes were registered prospectively. Follow up data were collected until March 2024 

Results: Between November 2017 and October 2023, 67 MDTs were held with participants from 18 countries and 20 centers. 260 patients were discussed (median 4 patients/session, range 1-12). Background data are shown in the table. The number of annual cases discussed has increased over time (+182% from 2017 to 2022), as is the median number of participants (+27% from 2020 to 2022). The MDTs resulted in a recommendation for pathological review and genetic sequencing in 24% and 9.6% of cases. Surveillance was recommended for 17% of cases. Alternative treatment opportunities were suggested for 58.7% of patients compared to the initial proposed management. Follow up data were available for 155 patients. Adherence to treatment recommendation was 94%. As a consequence of MDT recommendations, access to off-label therapies was achieved in 37 patients (23.8%) and 4 patients (2.5%) were enrolled in clinical trials abroad. [Text Wrapping Break] 

Table: 82MO 

Conclusions: EURACAN G2 domain MDTs increasingly offer opportunity for clinical support and access to treatment alternatives for patients with complex rare gynecological cancers. 

Legal entity responsible for the study: EURACAN G2 network. 

Funding: Has not received any funding. 

Disclosure: All authors have declared no conflicts of interest.