Profile and clinical outcomes of patients with thoracic tumors discussed at a tumor board in Brazil.

Abstract

e23137 Background: The thoracic oncology tumor board is a multidisciplinary forum essential for discussing and defining the best therapeutic strategies in complex cases of lung cancer and other thoracic tumors. Bringing together specialists in medical oncology, thoracic surgery, radiation therapy, radiology, and pathology, the tumor board aims to optimize individualized approaches, considering aspects such as staging, histology, biomarkers, and the patient's clinical conditions. This work aims to analyze the main clinical decisions made in a thoracic oncology tumor board, highlighting the impact of interdisciplinary collaboration on the quality of care and oncological outcomes. Methods: This is an epidemiological observational study, with case discussion of adult patients, over 18 years of age, with tumor located in the thorax, staging I-IV. 72 clinical cases discussions over 12 month period, from jan 2025 to dec 2025, in bi-weekly meetings in the participation multidisciplinary teams. Results: Most of the cases discussed were female and non-smokers. Approximately 70% of the cases were advanced or metastatic disease, with 82% being adenocarcinomas. PET-CT scans were used for staging in more than 80% of patients, and in 47% of cases, the management was modified after PET_TC analyses. The vast majority, 95%, were patients with private health insurance, and only 22% did not have a molecular profile at the time of clinical discussions. The main molecular alterations found were PD-L1 positivity and EGFR AGA in 20%. Despite the majority of patients having metastatic disease, a multidisciplinary approach was adopted in 30% of surgical procedures and 15% of radiotherapy. Tumor board evaluation led to management modifications in 72% of cases, demonstrating the importance and impact of multidisciplinary in thoracic oncology. Conclusions: In real-world thoracic tumor board experience in Brazil, MDT discussion led to management changes in 72% of cases, frequently driven by PET-CT based reassessment (47% changed after PET review) and occasional diagnostic reclassification (including benign diagnoses). The date support tumor board review as a pragmatic quality-improvement strategy in lung cancer care, reducing the time to treatment initiation and guiding management with an interdisciplinary perspective.