Mojica Christianne V, Pimentel Muniz Thiago, Wang Xin, Baker Stephanie, Edelstein Kim, Kanter Cheryl, Mileski Katherine, Nguyen Candice, Sekely Angela, Tsang Derek S, Hawkins Cynthia, Tabori Uri, Mason Warren P, Bennett Julie
Department of Medicine, Division of Neurology and Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Department of Medicine, Division Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Neurooncol Adv. 2025 Apr 11;7(1):vdaf072. doi: 10.1093/noajnl/vdaf072. eCollection 2025 Jan-Dec.
The distinct tumor histopathology, molecular features, and psychosocial needs among adolescents and young adults (AYA) with brain tumors pose challenges within traditional healthcare systems. Establishing a multidisciplinary AYA neuro-oncology clinic has been proposed to address these gaps in care. This is the first study to describe the framework and patient profile of a multidisciplinary AYA neuro-oncology clinic in a quaternary cancer center in Canada.
Clinic framework was outlined and patients seen from December 2022 to June 2024 were included. Demographic profiles, tumor characteristics, treatment details, clinical trial enrollment, and allied health referrals were collected. Barriers encountered were summarized.
The clinic is composed of specialists in pediatric and adult neuro-oncology with seamless referrals to neurosurgery, radiation oncology, and allied health teams. A total of 100 patients (males 54%, females 46%) were seen with a median age of 24 years. Pediatric-type low-grade glioma (PLGG) was the leading diagnosis. BRAF alterations were the primary molecular drivers. Twenty-nine patients received active neuro-oncology management in the clinic. Overall, 77 patients underwent at least one surgery, 31 patients received radiotherapy, and 43 patients received chemotherapy. Trametinib was the primary targeted treatment prescribed. Three patients were eligible and enrolled in clinical trials. Barriers identified included a lack of peer support groups and a paucity of available clinical trials.
This study provides insight into the clinical profile of patients seen in a multidisciplinary AYA neuro-oncology clinic in Canada. Multidisciplinary care is feasible and integral in addressing the multifaceted needs of AYAs with brain tumors.
患有脑肿瘤的青少年和青年（AYA）具有独特的肿瘤组织病理学、分子特征和心理社会需求，这给传统医疗系统带来了挑战。有人提议设立一个多学科的AYA神经肿瘤诊所来填补这些护理空白。这是第一项描述加拿大一家四级癌症中心多学科AYA神经肿瘤诊所的框架和患者概况的研究。
概述了诊所框架，并纳入了2022年12月至2024年6月期间就诊的患者。收集了人口统计学资料、肿瘤特征、治疗细节、临床试验入组情况和联合健康转诊情况。总结了遇到的障碍。
该诊所由儿科和成人神经肿瘤专家组成，可无缝转诊至神经外科、放射肿瘤学和联合健康团队。共诊治了100名患者（男性占54%，女性占46%），中位年龄为24岁。小儿型低级别胶质瘤（PLGG）是主要诊断。BRAF改变是主要的分子驱动因素。29名患者在诊所接受了积极的神经肿瘤治疗。总体而言，77名患者至少接受了一次手术，31名患者接受了放疗，43名患者接受了化疗。曲美替尼是主要开具的靶向治疗药物。3名患者符合条件并参加了临床试验。确定的障碍包括缺乏同伴支持小组和可用的临床试验较少。
本研究深入了解了加拿大一家多学科AYA神经肿瘤诊所中患者的临床概况。多学科护理对于满足患有脑肿瘤的AYA的多方面需求是可行且不可或缺的。
