National Ewing’s Sarcoma Tumor Board Connects Experts, Facilitates Discussion

Physicians treating patients with Ewing’s sarcoma will get a chance to discuss challenging cases with experts from Cleveland Clinic and other leading cancer centers throughout the country in a new National Ewing Sarcoma Tumor Board.

The board brings together a multidisciplinary group of specialists to review and discuss cases once a month. Its goal is to support physicians in rural or smaller hospitals by giving them access to expertise and resources from some of the nation’s foremost Ewing’s sarcoma specialists.

“We have a very strong sarcoma team and provide a large number of second opinions formally,” says Matteo Trucco, MD, a Cleveland Clinic pediatric oncologist who is leading the tumor board. “This is a way to help educate clinicians without as much experience with this rare tumor in an informal way.”

How it started

The project started with inspiration and support from foundations focused on Ewing’s sarcoma and motivated Cleveland Clinic’s sarcoma program to establish a more specialized Ewing’s sarcoma tumor board. Cleveland Clinic Cancer Center and Cleveland Clinic Children’s will be leading the effort, with experts from MD Anderson Cancer Center, Dana Farber Cancer Institute and other major cancer centers joining the panel. It’s the first tumor board of its kind in the United States.

“It’s really a team effort, inspired by patients,” Dr. Trucco says.

Ewing sarcoma is a rare cancer, affecting around 200 children and a handful of adults each year. Studies have found that patients who are treated by specialists at sarcoma centers tend to have better outcomes, but many cases are handled by oncologists at smaller regional or community hospitals. The tumor board is intended to help those physicians and patients, Dr. Trucco says.

How it works

As for who can submit a case for review by the board, Dr. Trucco says that patients who have relapsed multiple times, or who have medical complications that make them difficult to treat with the standard regimen would be good candidates.

“Those are the cases that require a little more discussion, a little more thought, a little more expertise, or they may require a surgery or radiation that may be a little trickier to deliver,” Dr. Trucco says. Cases must be submitted by the physician, he notes.

The board will have a secure portal through which the physician can submit an intake form describing the case, treatment so far, and what clinical question they wish to discuss. The board will review around four cases per month. The program is scheduled to launch on July 12, 2021. Virtual meetings will be held at 5 p.m. Eastern Time on the second Monday of each month.

Adult and pediatric medical oncologists, radiation oncologists, surgical oncologists, orthopedic tumor surgeons, and anyone else in the medical community with an interest in Ewing sarcoma is invited to attend. To protect patients’ privacy, meetings will not be open to patients or families of patients with Ewing’s sarcoma.

What to expect

The format for the meeting will include a slide presentation by the treating physician, providing background on the case and presenting pathology, scans, and molecular analysis of the tumor, if available. Discussion will follow with board members asking questions and offering ideas. Cases will be reviewed without any identifying information about the patient, he notes.

“Nothing is formal, no one will have seen the patient or reviewed the complete medical record, but we can offer some suggestions, some thoughts. ‘Have you thought about this? Have you looked at that?’ ‘Maybe reach out to this person who has a clinical trial nearby,’” Dr. Trucco says.

If the physician or family wants to pursue a formal consultation with Cleveland Clinic or any other institution after the review, that can be pursued separately, he adds.

The Cleveland Clinic Cancer Center is a leader in treating Ewing’s sarcoma, with some of the country’s top specialists in medical oncology, pediatric oncology, radiation oncology, orthopedic surgery and thoracic surgery, as well as one of the top pathology departments in the country for sarcomas.

For more information about the National Ewing Sarcoma Tumor Board, or to submit a case for review, visit https://redcap.link/ewing_ccf.

Editor’s note: This forum is for educational discussions only; it does not obviate the need for a second opinion or clinical consultation, and the presenting physician is solely responsible for the patient’s treatment plan.