Os12.7.a implementation of a national aya molecular tumor board: report from the canadian aya neuro-oncology network

Abstract BACKGROUND The adolescent and young adult (AYA) population (15-39 years) is a unique and understudied population within neuro-oncology, and their care requires expertise across pediatric and adult-type brain tumors. Current challenges in AYA neuro-oncology include fragmented care across pediatric and adult hospitals, low inclusion in clinical trials, unique survivorship considerations and a lack of standard-of-care therapies for this population. MATERIAL AND METHODS We report on a two-year national effort from the Canadian AYA Neuro-Oncology Network (CANON) to implement national AYA rounds. The aims of the rounds are to discuss challenging cases, encourage and review the utility standardized molecular testing, and provide point-of-care multidisciplinary recommendations benefiting from the expertise of pediatric and adult providers across several tertiary and community centers. RESULTS Since April 2021, the Canadian national AYA rounds have occurred biweekly on a virtual secure platform. Over 2 years, 138 cases have been discussed; 23% of patients were 15-20 years old, 33% were 21-30 years old and 26% were 31-40 years old. Cases discussed included low grade gliomas (39%), followed by high grade gliomas (33%), ependymomas (6.5%), medulloblastomas (6.5%) and others (9.4%). A total of 240 participants across 25 institutions across Canada have attended the rounds, spanning adult and pediatric neurosurgery, neuro-pathology, neuro-oncology, radiation oncology and radiology. A prospective database of cases presented at our AYA rounds, matching molecular characterization, choice of therapies and relevant clinical outcomes has been initiated and interim data will be presented at the meeting. CONCLUSION Virtual national AYA-neuro-oncology multi-disciplinary rounds have raised awareness of current gaps and possible nation-wide solutions to improve the care of AYA brain tumors. Leveraging this network, our group has published guidelines for molecular testing in AYA brain tumors and is employing this platform for ongoing research and clinical collaborations.