INNV-27. A coordinated care model for multidisciplinary meningioma treatment and research

Abstract The care of patients with meningioma is often multidisciplinary due to potential tumor and treatment morbidity, evolving biomarkers, high rates of recurrence in select subgroups, and emerging systemic therapies. UCSF previously convened two tumor boards for adult brain tumor patients, one general (median 14 patients/week, range 4-25) and one specific for stereotactic radiosurgery (median 13 patients/week, range 5-28). Due to patient volume, a separate meningioma multidisciplinary tumor board (MMTB) and meningioma multidisciplinary clinic (MMDC) were initiated in 9/2024. The UCSF MMTB is a weekly meeting of healthcare providers from neurosurgery, radiation oncology, neuro-oncology, neuropathology, neuroradiology, and neuro-ophthalmology (median 20 providers/week, range 11-24). Next-generation sequencing is performed on all resected meningiomas, and results of molecular testing, imaging studies, and therapeutic interventions are reported at the UCSF MMTB. Postoperative cases are seen in-house by a nurse practitioner to establish continuity of care (median 13 consults/month). From 9/2024 to 5/2025, the UCSF MMTB discussed 421 cases (median 13 patients/week, range 5-23, 34.5% recurrent). An additional 219 cases screened out of discussion based on reassuring histological and molecular features (median 21 total patients triaged/week, range 10-36). Median age was 63 years (range 14-89) and 62% were female. Meningioma WHO grades were 37% grade 1, 26.4% grade 2, 6.4% grade 3, and 30.2% imaging-defined. MMTB recommendations consisted of observation (36.3%), radiosurgery (38.4%), radiotherapy (27.4%), surgery (21.0%), systemic therapy (14.2% overall, 38.5% of WHO grade 2 or 3 meningiomas), and DOTATATE-PET (19.9%). Clinical trial enrollment was offered to 9.9% of patients, and prospective registry enrollment was offered to 83.6%. All patients were referred to neuro-oncology, 50.5% to radiation oncology, 18.9% to neurosurgery, and 29.5% to the UCSF MMDC (73.3% seen in consultation on the same day of MMTB). In summary, a tumor board and multidisciplinary clinic is a scalable model for coordinated meningioma care and research.