(P 227) TREATMENT PATTERNS IN PATIENTS WITH TENOSYNOVIAL GIANT CELL TUMORS: ADDRESSING COMMUNICATION IN A NEW THERAPEUTIC LANDSCAPE

Objective: Tenosynovial giant cell tumors (TGCTs) are benign neoplasms that can arise from synovial tissues and can be locally aggressive. TGCT treatment has primarily relied on surgical resection, but recent development of systemic therapies provides a non-surgical option. Indications for systemic therapy for TGCTs outside of clinical trials vary, requiring discourse between patients and their medical team providers. The purpose of this study is to identify patterns of multidisciplinary care of TGCTs at a large academic institution.

Methods: Patient and disease characteristics, treatment data, and referral patterns were extracted from the electronic medical record. Quantitative analysis was completed using summary statistics. Qualitative data was obtained through anonymous patient surveys to evaluate patient-provider communication and knowledge regarding TGCT management.

Results: Fifty-four patients were included in this study. Most underwent initial surgery (79.6%), and seventeen individuals (40%) underwent additional surgical procedures. Twelve patients received systemic therapy with pexidartinib or imatinib, and a majority (83.4%) experienced radiographic and/or symptomatic improvement after starting systemic therapy. Indications for systemic therapy ranged from recurrent/extensive disease to high-risk of morbidity associated with additional surgery. The most common referral pattern noted within our institution involved initial evaluation by orthopedic surgery or orthopedic oncology with subsequent surgery or discussion at a multidisciplinary tumor board.

Seventeen patients completed the survey. 14/17 reported good communication overall, but 6/17 were unfamiliar with or did not discuss any non-surgical treatment options. No knowledge question had greater than 50% correct responses.

Conclusion: Treatment of individuals with TGCT at our institution involved providers across various specialties and coordination with support services. With medical therapy emerging as both safe and effective, we propose a change to the historical referral pattern for patients specifically with recurrent TGCTs or external diagnoses to include an initial evaluation by both orthopedic and medical oncology, ideally at a multidisciplinary tumor board, to optimize patient understanding of all treatment options.

TGCT Treatment Characteristics