82MO European multi-disciplinary tumor boards within the EURACAN network increasingly support management of patients with rare gynaecological tumors: 6-year activity results

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. 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. 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.Table: 82MOPatients N=260DIAGNOSISGestational trophoblastic disease51 (19.6%)Malignant ovarian germ cell tumors51 (19.6%)Sex cord stromal tumors38 (14.6%)Other Rare ovarian histologies76 (29.2%)Rare uterine tumors20 (7.8%)Rare cervical tumors11 (4.2%)Other13 (5%)PREVIOUS LINES OF TREATMENT (median, range)1 (0-10)INDICATIONS FOR DISCUSSION*Initial management117 (42.5%)Relapse/disease Progression133 (48.4%)Other (follow up, further investigation)25 (9.1%)* N= 275 case discussions. Open table in a new tab * N= 275 case discussions. EURACAN G2 domain MDTs increasingly offer opportunity for clinical support and access to treatment alternatives for patients with complex rare gynecological cancers.