2443 - Multidisciplinary Team (MDT) Perceptions toward the Treatment of Limited-Stage Small-Cell Lung Cancer (LS-SCLC): A U.S. Physician Survey

Purpose/Objective(s): In the United States (US), lung cancer continues to be one of the most common cancers diagnosed and the leading cause of cancer-related mortality, with SCLC representing around 15% of cases, one-third of which are diagnosed as LS-SCLC. Treatment paradigms for LS-SCLC have remained unchanged for decades, focusing on MDT care and coordination, with treatments including chemoradiation (CRT) for the majority of patients and surgery for select eligible patients. This study aimed to describe US healthcare professionals’ (HCPs) reported barriers to prescribing concurrent CRT (cCRT), the current standard of care (SoC), and to explore factors influencing the uptake of immunotherapies (IOs) in light of the successful ADRIATIC trial.

Materials/Methods: We conducted a quantitative survey and used a physician panel to identify eligible survey respondents. Eligibility criteria included being a US-based HCP, being a licensed radiation oncologist or medical oncologist, and having seen at least 3 SCLC patients in the 12 months prior to the survey. Individual 30-minute close-ended surveys were conducted, with HCPs consulted on the design of the survey to ensure questions were relevant to real-world practice and complete in-terms of response options.

Results: Of the 177 HCPs included in the survey, 50.8% and 49.2% were radiation oncologists and medical oncologists respectively. Primary practice setting for HCPs included 46.3% in cancer centers, 17.5% in university hospitals, 15.3% in community hospitals with academic affiliations, and 29.4% in community hospitals without academic affiliations. The majority (94.9%) of HCPs reported being part of an MDT, with 53.4% of HPCs reporting weekly MDT meetings and 42.4% of HCPs reported having both in-person and virtual MDT meetings. HCPs cited the main barriers to prescribing cCRT were patient comorbidities (48.6%), toxicity of treatment (46.9%), and patient performance status (41.2%). HCPs reported factors for abstaining from prescribing IOs included IO-related side effects (37.9%), radiotherapy-related pneumonitis (32.8%), and patient preference (31.1%). Finally, factors influencing prophylactic cranial irradiation (PCI) prescription included concerns for patients’ cognitive decline (54.9%), patient refusal (53.7%), and no evidence of brain metastasis on imaging (40.9%).

Conclusion: While access to cCRT is often regarded as a major barrier to care, this real-world survey conducted among US radiation oncologists and medical oncologists identified factors related to patients’ toxicity profile and tolerability as the main barriers. These findings emphasize the importance of HCP education around toxicity management and patient education on the benefits of treatment, as well as the need for further research into tolerability to cCRT, as it remains the SoC and the backbone of new and emerging therapeutic regimens.