(P 310) TUMOR REVIEW BOARD FOR OSTEOSARCOMA (TURBO): BIMONTHLY, MULTI-INSTITUTIONAL, MULTIDISCIPLINARY VIRTUAL TUMOR BOARD FOR OSTEOSARCOMA

Objective: The care of patients with osteosarcoma requires a multidisciplinary team. It is generally recommended for patients with sarcomas to be treated at high volume Sarcoma Centers by physicians with experience and expertise in their management. This, however, is not always possible and the rarity of these cancers makes gaining such experience difficult for smaller and community practices. There is often limited data to help guide treatment of particularly challenging cases, especially those involving unusual locations, relapsed and metastatic disease. Tumor Review Board for Osteosarcoma (TURBO) provides a multi-institutional, multidisciplinary, virtual tumor board exclusively for Osteosarcoma to discuss and share knowledge, strategies, available clinical trials and expert opinions related to these challenging cases. We believe there is value in discussing cases together given unique features of many cases and the complexity of individualized decision-making in the care of Osteosarcoma patients and that we can all learn together to refine our thinking about these cases.

Methods: In February 2022, the non-profit foundation Make It Better (MIB) Agents, in collaboration with physicians from multiple sarcoma centers, using the OncoLens™ platform, launched TURBO to discuss challenging new and relapsed Osteosarcoma cases. Through this forum, the combined knowledge and expertise of an experienced group of clinicians focused on this cancer is shared. At each meeting, two to four cases, without protected health information, are presented by the treating physicians. Of note, patients do not participate in the tumor board, but can ask their physicians to present their case. Presentations include clinical history, histology, molecular pathology, radiology, medical treatments, surgeries, radiation treatments, any other pertinent information and specific questions for the group. A multidisciplinary team including medical oncologists, pediatric oncologists, pathologists, radiologists, orthopedic, thoracic and general surgeons, interventional radiologists and radiation oncologists then participates in the discussion of the case. A summary of the discussion is provided to the presenting physician upon conclusion of the meeting.

Results: As of June 2022, three bimonthly virtual tumor boards have been held. A total of 10 cases, from 8 different institutions, were discussed. With about half the cases coming from high-volume sarcoma centers and half from smaller programs. Attendance has varied from 26-40 participants, with a consistent upward trend. Discussions have included local control strategies, approach to patients who have completed therapy but are at high risk for recurrence, management of osteosarcoma in unique locations such as the mandible, and management of recurrent and metastatic disease. There have been cases where there has been complete consensus and others where differing opinions were generated. Frequently, information regarding available clinical trials is shared during the tumor board.

Conclusion: TURBO provides a forum where several clinicians from a variety of specialties and institutions, all focused on Osteosarcoma, can share their experience and expertise to educate the group as a whole. While early in its inception, several cases have been discussed from multiple institutions, with a variety of clinical questions, and participation has steadily increased. With an assembled group of key opinion leaders discussing unique cases, we anticipate building a more structured assessment of expert opinions to inform pathways for care when consensus exists and research opportunities, perhaps through cohort studies, when practice varies across institutions. TURBO also represents a collaborative effort between clinicians and a patient advocacy group to develop a venue for the sharing of knowledge and experience.