Abstract P5-16-03: Global Cancer Institute online breast tumor boards: A tool to facilitate multidisciplinary discussions in resource-limited settings
Authors: Espalter MC , Moreno J , Hambardzumyan V , Goss PE 
Published: February 2018

Abstract
Background: Multidisciplinary tumor boards (MTBs) are commonly practiced among specialists in high-income countries (HICs) to ensure evidence-based, concordant decisions for patient treatment. MTBs have also been shown to improve patient outcomes and quality of life. Cancer specialists in low-and middle-income countries (LMICs) have limited time and few opportunities to discuss breast cancer patient care with colleagues. The Global Cancer Institute (GCI) established online MTBs in 2012 to facilitate live telemedicine discussions of breast cancer case scenarios between specialists in LMICs and expert specialists in HICs. GCI MTBs aim to improve clinical knowledge and patterns of practice among specialists in LMICs with a low-cost, interactive, and educational tool.
Methods: In each monthly, hour-long MTB, three de-identified breast patient case scenarios are presented in English by specialists in LMICs for live discussion with a multidisciplinary expert panel of breast specialists based in the US. Discussions are held for each case scenario and provide an overview of evidence-based treatment, international and resource-stratified clinical guidelines, clinical trials, and best clinical practices for limited resource settings. After each MTB, links to clinical practice guidelines, clinical trials, and other resources are shared with MTB attendees. For educational purposes, each MTB is privately live-streamed online and uploaded to a private YouTube channel for viewing by cancer specialists and trainees worldwide.
Results: The GCI MTB program has interacted with over 500 participants from 44 hospitals in 25 LMIC countries across Latin America (LA), Eastern Europe, Africa, and Asia. 17 expert breast cancer specialists from 10 US cancer centers provide multidisciplinary guidance for each case.
To date, 142 breast cancer case scenarios have been presented. For breast MTBs, 83% of case scenarios were invasive ductal carcinomas. Common subtypes presented were ER/PR+ (62%), HER2+ (31%), and triple negative disease (29%). 60 cases (43%) involved management of advanced disease in resource-limited settings.
Conclusions: GCI MTBs are a low-cost educational tool for specialists in LMICs to improve patterns of clinical practice and engage in multidisciplinary discussions with colleagues. GCI continues to expand its MTB among cancer facilities in LMICs worldwide. GCI will pilot the implementation of a LA-based online MTB conducted in Spanish for wider participation of community and rural/remote breast cancer specialists in the region.
Citation Format: St. Louis J, Espalter MC, Moreno J, Hambardzumyan V, Goss PE. Global Cancer Institute online breast tumor boards: A tool to facilitate multidisciplinary discussions in resource-limited settings [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-16-03.