82MO – European multi-disciplinary tumor boards within the EURACAN network increasingly support management of patients with rare gynaecological tumors: 6 year activity results<\/p>\n
A. Bergamini1<\/sup>, U. Joneborg2<\/sup>, G. Marquina3<\/sup>, E. Grassi4<\/sup>, E. Wallin2<\/sup>, A. Casado Herraez5<\/sup>, O. Solheim6<\/sup>, C.M. Sassu7<\/sup>, C. Lok8<\/sup>, M. Bini9<\/sup>, P. Pautier10<\/sup>, F. Kridelka11<\/sup>, J. Sehouli12<\/sup>, E. Van Nieuwenhuysen13<\/sup>, J. Coulter14<\/sup>, P-A. Bolze15<\/sup>, C. Lebreton16<\/sup>, P. Jurgen17<\/sup>, I.L. Ray-Coquard18<\/sup>, M.J. Seckl19<\/sup> [Text Wrapping Break]1<\/sup>Gynaecological Oncology, IRCCS Ospedale San Raffaele, Milan, Italy, 2<\/sup>2. Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden, 3<\/sup>Medical Oncology, Hospital Clinico Universitario San Carlos, Madrid, Spain, 4<\/sup>1. Department of Gynaecological Oncology, IRCCS Ospedale San Raffaele, Milan, Italy, 5<\/sup>Medical Oncology Department, Hospital Clinico Universitario San Carlos, Madrid, Spain, 6<\/sup>Sep.of Gynacological Oncology, Oslo University Hospital – The Norwegian Radium Hospital, Oslo, Norway, 7<\/sup>Dipartimento Scienze della Salute della Donna, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy, 8<\/sup>Gynecologic Oncology, NKI-AVL – Netherlands Cancer Institute\/Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands, 9<\/sup>Dipartimento di Oncologia, Istituto Nazionale dei Tumori di Milano – Fondazione IRCCS, Milan, Italy, 10<\/sup>Medicine Department, Institut Gustave Roussy, Villejuif, France, 11<\/sup>Chu de Liege, CHU de Li\u00e8ge – Sart Tilman Site, Li\u00e8ge, Belgium, 12<\/sup>Gynecology, Charit\u00e9 – Universitaetsmedizin Berlin, Berlin, Germany, 13<\/sup>Gynaecological Oncology Department, UZ Leuven – University Hospitals Leuven – Campus Gasthuisberg, Leuven, Belgium, 14<\/sup>12. Department of Gynaecological Oncology, CUH – Cork University Hospital, Cork, Ireland, 15<\/sup>Centre Fran\u00e7ais de R\u00e9f\u00e9rence des Maladies Trophoblastiques, CICLY – Centre pour l’lnnovation en Canc\u00e9rologie de Lyon – Universit\u00e9 Lyon 1-EA 3738, Oullins, France, 16<\/sup>Medical Oncology Department, Institute Bergoni\u00e9 – Centre R\u00e9gional de Lutte Contre le Cancer (CLCC), Bordeaux, France, 17<\/sup>15. Department of Obstetrics and Gynecology, Catharina Hospital Eindhoven, Eindhoven, Netherlands, 18<\/sup>Medical Oncology Department, Centre L\u00e9on B\u00e9rard, Lyon, France, 19<\/sup>Surgery and Cancer Department, Charing Cross Hospital – Imperial College Healthcare NHS Trust, London, UK <\/p>\n Background: <\/strong>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. <\/p>\n Methods: <\/strong>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 <\/p>\n Results: <\/strong>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] <\/p>\n Patients N=260 <\/p>\n<\/td>\n DIAGNOSIS <\/p>\n<\/td>\n Gestational trophoblastic disease <\/p>\n<\/td>\n 51(19.6%) <\/p>\n<\/td>\n<\/tr>\n Malignant ovarian germ cell tumors <\/p>\n<\/td>\n 51 (19.6%) <\/p>\n<\/td>\n<\/tr>\n Sex cord stromal tumors <\/p>\n<\/td>\n 38 (14.6%) <\/p>\n<\/td>\n<\/tr>\n Other Rare ovarian histologies <\/p>\n<\/td>\n 76 (29.2%) <\/p>\n<\/td>\n<\/tr>\n Rare uterine tumors <\/p>\n<\/td>\n 20 (7.8%) <\/p>\n<\/td>\n<\/tr>\n Rare cervical tumors <\/p>\n<\/td>\n 11 (4.2%) <\/p>\n<\/td>\n<\/tr>\n Other <\/p>\n<\/td>\n 13 (5%) <\/p>\n<\/td>\n<\/tr>\n PREVIOUS LINES OF TREATMENT(median, range) <\/p>\n<\/td>\n 1 (0-10) <\/p>\n<\/td>\n<\/tr>\n INDICATIONS FOR DISCUSSION* <\/p>\n<\/td>\n Initial management <\/p>\n<\/td>\n 117(42.5%) <\/p>\n<\/td>\n<\/tr>\n Relapse\/disease Progression <\/p>\n<\/td>\n 133(48.4%) <\/p>\n<\/td>\n<\/tr>\n Other (follow up, further investigation) <\/p>\n<\/td>\n 25(9.1%) <\/p>\n<\/td>\n<\/tr>\n * N= 275 case discussions <\/p>\n<\/td>\n<\/tr>\n<\/table>\n Conclusions: <\/strong>EURACAN G2 domain MDTs increasingly offer opportunity for clinical support and access to treatment alternatives for patients with complex rare gynecological cancers. <\/p>\n Legal entity responsible for the study: <\/strong>EURACAN G2 network. <\/p>\nTable: 82MO <\/h3>\n
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