Multidisciplinary adolescent and young adult neuro-oncology clinic: Clinical cases, practice challenges, and future perspectives

TL;DR

This study describes a new clinic in Canada for young adults with brain tumors, showing how multidisciplinary care can better meet their unique medical and social needs.

Contribution

The first description of a multidisciplinary AYA neuro-oncology clinic framework and patient profile in Canada.

Findings

The clinic primarily treated patients with pediatric-type low-grade gliomas and BRAF alterations.

Multidisciplinary care included surgery, chemotherapy, and targeted treatments like Trametinib.

Barriers included limited peer support and few clinical trial opportunities for AYA patients.

Abstract

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.

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