Abstract 139P
Background
MDTs need to make increasingly complex decisions as early-stage NSCLC treatment (Tx) options have expanded. Here, we report the results of qualitative interviews with healthcare professionals (HCPs) on MDT dynamics in managing stage IB–IIIB NSCLC, as part of an ongoing global MDT study.
Methods
The following countries were selected to represent different levels of MDT establishment and access to new Tx: Brazil, Canada, Germany, Italy, Japan, Mexico, Spain, Switzerland, Turkey, UK, and US. Oncologists, surgeons, pulmonologists, pathologists and radiation oncologists who have managed ≥5 patients with stage IB–IIIB NSCLC (AJCC 8th ed) in the year prior to eligibility screening, have practiced ≥3 years, are licensed and board certified/eligible, and spend >60% (community HCPs) or >30% (academic HCPs) of time in clinical practice were asked open-ended questions in 60-minute telephone interviews by a trained moderator in their local language. Thematic analysis was performed.
Results
109 HCPs from academic (59%) and community settings (41%) across 11 targeted countries were interviewed. Interview topics and key findings are summarised in the table. Academic settings had more developed and formal MDTs compared to community settings. MDTs often discussed complex cases due to multiple Tx options. In addition to other barriers for successful MDT involvement (Table), there is an unmet need for operational guidelines to inform MDT meeting logistics and standardise practice, the existence/use of which is highly variable across countries.
Table 139P| Topic | Findings |
| MDT dynamics | Formal meetings ensure collaboration |
| Complex cases discussed more MDT establishment varied by country and academic vs community setting | |
| Drivers and barriers to successful MDT involvement | Drivers: multispecialty representation, availability of diagnostic (Dx) details, time management, effective communication and administrative support |
| Barriers: time constraints, delays in Dx details, non-attendance and poor infrastructure | |
| Biomarker testing practices Impact of MDT dynamics on Tx selection | EGFR, PD-L1 and ALK tests are the most critical Integration has many barriers (e.g. high cost) Each specialty has differing opinions Leads to faster Tx decisions |
Conclusions
Formal MDT meetings with different specialists are necessary to drive tailored care in early-stage NSCLC, but some countries have limited MDT capabilities. The next phase of this study, a quantitative survey and patient chart review, will shed further light on MDT practices across global geographies and their impact on Tx selection.
Editorial acknowledgement
Medical writing support for the development of this abstract, under the direction of the authors, was provided by Andrew Gannon (New York, NY, USA) and Matthew Hallam (Macclesfield, UK) of Ashfield MedComms, an Inizio company, and was funded by AstraZeneca.
Legal entity responsible for the study
AstraZeneca.
Funding
AstraZeneca.
Disclosure
T.A. Leal: Financial Interests, Personal, Invited speaker: OncLive, Medscape, PeerView, Curio, Aptitude Health, Ideology, CME Outfitters, Bio Ascend, GASCO, Targeted Oncology, GRACE, and SITC; Financial Interests, Personal, Writing engagements: UpToDate; Financial Interests, Personal, Advisory board: Roche, AstraZeneca, Amgen, Janssen, Bristol Myers Squibb, Pfizer, Black Diamond, and Boehringer Ingelheim; Non-Financial Interests, Personal and Institutional, Member of board of directors: GASCO; Financial Interests, Personal and Institutional, Full or part-time employment: Emory University; Financial Interests, Institutional, Research grant: DSI; Financial Interests, Personal, Advisory role: Janssen, Gilead, Novocure, OncoC4, and AbbVie; Financial Interests, Personal and Institutional, Leadership role: Thoracic Oncology Program Director. H. Bahig: Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Institutional, Research Grant: Varian Medical Systems; Financial Interests, Institutional, Principal Investigator: Varian Medical Systems. C. Finlayson, R. Rawlinson: Financial Interests, Institutional, Sponsor/Funding: AstraZeneca. D. Simmons, M.K. Shanahan, M. Mancy: Financial Interests, Personal, Full or part-time Employment: AstraZeneca. Y. Qiao: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Stocks/Shares: AstraZeneca. All other authors have declared no conflicts of interest.