MMDA-21 IMPACT OF MULTI-DISCIPLINARY TEAM ON TREATMENT OPTIONS AND PATTERNS OF CARE FOR PATIENTS CNS METASTASIS
Evan Adler, Liesl Eibschutz, Nile Liu, Joslyn Hayoung Jung, Mu-Hsun Chen, Hong Zhu, Varinder KaurAbstract
Background
Incidence of solid tumor brain metastasis is on the rise due to improved systemic therapy options and survival of patients with several malignancies. With this in mind, the aim of our study was to explore the pattern of multi-modality treatment options for patients with CNS metastasis and patient outcomes.
Methods
We conducted a retrospective analysis of patients with CNS metastasis from solid tumors who received multi-disciplinary care at the University of Virginia from 2020-2025. Median overall survival (OS) and CNS progression-free survival (PFS) were estimated using the Kaplan-Meier method.
Results
Of the 41 patients studied, 43.9% (n = 18) were male, while 56.1% (n = 23) were female. Median age at cancer diagnosis was 59 years. Most common primary cancers were NSCLC (34.1%, n = 14), breast (26.8%, n = 11), and melanoma (17.1%, n = 7). Median time from solid tumor diagnosis to CNS metastasis was 30.4 months. 41.5% (n = 17) had solitary brain metastasis, 31.7% (n = 13) had 1 to 5, 14.6% (n = 6) had 6 to 10, and 12.2% (n = 5) had over 10 brain metastases. Most patients received a combination of systemic and loco-regional therapy (51.2%, n = 21). Six patients (14.6%) received systemic therapy alone, and 13 patients (31.7%) received loco-regional therapy alone. For first line systemic therapy, 39.0% (n = 16) received targeted therapy, 34.1% (n = 14) received chemotherapy, and 19.5% (n = 8) received immunotherapy. For loco-regional therapy, 58.5% (n = 24) patients received SRS (including GKRS), 26.8 % (n = 11) underwent surgical resection, and 4.9% (n = 2) received WBRT. Median OS was 55.4 (95% CI: 31.8-not estimable) months from development of CNS metastasis, and median PFS was 9.0 (95% CI: 6.9-16.1) months. Median time from diagnosis of CNS metastasis to specialist consultation was 3 days.
Conclusions
Patients with CNS metastasis from solid tumors represent a complex patient population. Provision of multidisciplinary care offers potential for faster access to specialized care and improved survival outcomes.