Multidisciplinary tumor boards have become an essential component for the care of patients with cancer. Many countries require all hospitals that take care of patients with cancer hold tumor board meetings. A large number of countries even require tumor board decisions in order to have surgeries or medications approved. Comprehensive cancer centers, standalone cancer centers, and university hospitals have also gone far beyond requirements and hold various specialty tumor boards (breast, GI, thoracic, GU, leukemia, lymphoma, GYN, and others). However, for large numbers of patients whose surgeons and oncologists are in private practice and private hospitals, their cases do not always make it to tumor boards unless their physician is affiliated with a university hospital, or makes extra efforts to present cases at nearby university hospitals. It was reassuring that a survey of ASCO’s international membership reported very significant utilization of tumor boards.^1,2 Mini-tumor boards were also of great interest when a full team from all specialists is not available.^1,2 Some international meetings, like the San Antonio Breast Cancer Symposium, organize highly attended tumor board sessions; the European Society for Medical Oncology (ESMO) organizes ESMO Guidelines sessions that include case presentations and discussions.

At our two-day annual Beirut Breast Cancer Conference (BBCC), held February 10-11, 2023, we increased the number of tumor board sessions to four this year. We prepare two cases with slides that include case presentation, images, and a brief literature review, and we open the floor for attendees to present their cases. We have a moderator and a multidisciplinary panel for each session. While I, in person, moderated one tumor board, it was a nice challenge for Dr. Diana Lake of Memorial Sloan Kettering Cancer Center (MSKCC), Dr. Hesham Al-Ghazaly of Ain Shams University, and Dr. Ahmad Awada of Institut Jules Bordet to moderate discussions remotely from New York, Cairo, and Brussels, respectively, in our hybrid BBCC-11 meeting that included in-person and virtual attendees who all participated in the discussions. It is amazing how far we have advanced in utilizing technology and IT expertise for the dissemination of medical knowledge, and of course for networking and research discussions!

A tumor board session at BBCC11.

As virtual meetings are here to stay,³ hybrid ones also. Although the number of in-person attendees may decrease, the number of virtual attendees increases in hybrid meetings. Hybrid format allows us to invite expert speakers who may not have the time to travel, and it also allows us to invite expert speakers when we do not have the money to cover their travel costs. At BBCC-11, the hybrid format allowed us to have three virtual keynote lectures by Dr. Mark Robson of MSKCC on systemic therapy for women with inherited breast cancer, Dr. David Cameron of the University of Edinburgh on antibody-drug conjugates for HER2+ breast cancer, and Dr. Mahmoud El-Tamer of MSKCC on surgical management of invasive lobular carcinoma. We also had great presentations by a superb faculty of Lebanese, Arab, European and American speakers, local research presentations by residents and fellows, as well as oncology pharmacy, nursing, and advocacy sessions.

Our meeting included an Opening Ceremony panel debate with Ministers of Health, Finance, National Social Security Fund, physicians, hospital administrators, and drug manufacturing and importing syndicate presidents, moderated by Lebanese TV anchor Ms. Hoda Chedid where we discussed drug shortages and difficulties that patients have in accessing treatment in low-income countries, and specifically in Lebanon which is in a deep economic crisis.

The Opening Ceremony panel at BBCC11.

We have a tradition of including arts in our Closing Ceremony. This year we enjoyed a very nice Arabic music and piano concert performed by our own medical chief resident Dr. Farah Jaber and medical student Rashad Nawfal.

BBCC11 attendees and performers at the Closing Ceremony concert.

References

1. El Saghir NS, Keating NL, Carlson RW, et al. Tumor boards: optimizing the structure and improving efficiency of multidisciplinary management of patients with cancer worldwide. Am Soc Clin Oncol Educ Book. 2014:e461-6.
2. El Saghir NS, Charara RN, Kreidieh FY, et al. Global Practice and Efficiency of Multidisciplinary Tumor Boards: Results of an ASCO Survey. J Glob Oncol. 2015;1:57-64.
3. El Saghir NS. Virtual Meetings Are Here to Stay. ASCO Post. May 10, 2021.