Introduction The coronavirus disease 2019 (COVID-19) pandemic has resulted in a widespread adoption of telehealth (phone and video consultations) in cancer care worldwide. The aim of this study was to determine patient satisfaction with telehealth consultations with their medical oncologist at a tertiary cancer centre in Sydney, Australia. Methods Patients who attended a routine telehealth appointment at the medical oncology outpatient clinic were recruited to complete a questionnaire containing 16 items, each on a 5-point Likert scale regarding satisfaction levels in various aspects of telehealth and their willingness to continue telehealth after the pandemic. Patients were also invited to provide suggestions for improvement. Results In total, 150 patients were invited to participate, and 103 valid questionnaires were returned. Median age was 63 years (range: 25–90), 49% of patients were male, 63% of patients had advanced cancer and 81% were on active treatment. In total, 95% of participants indicated that they were satisfied (score ≥4) with telehealth. 82% of participants preferred to continue telehealth consultations after the coronavirus disease 2019 pandemic, but ideally with a mix of telehealth and in-person consultations. Phone appointments (vs. video, p < 0.002), patients with advanced cancer (vs. early, p < 0.036) and pre-chemotherapy/immunotherapy/targeted therapy treatment reviews (vs. follow-up appointments, p < 0.001) were significantly associated with a willingness to continue telehealth. Discussion Patients were overwhelmingly satisfied with telehealth during the study period and were willing to continue telehealth for some appointments beyond the coronavirus disease 2019 pandemic. More research into the effectiveness, safety and implementation of telehealth to compliment traditional face-to-face services for patient-centred cancer care is required.

Background: Neoadjuvant therapy may increase the likelihood of complete (R0) resection for borderline resectable pancreatic cancer. The optimal approach is unknown and differs amongst treatment centres. Methods: We identified patients with biopsy-proven borderline resectable pancreatic adenocarcinoma who commenced neoadjuvant therapy between January 2012 and June 2019 at three centres in Sydney, Australia. Patterns of care and outcomes of varying approaches were examined. Results: Forty-eight patients were identified. Median age was 66 years (range: 41-84). Staging included endoscopic ultrasound in 98%, PET-CT scan in 77%, laparoscopy in 46%. Neoadjuvant regimens used were a combination of chemotherapy and chemo-radiation (58%), chemotherapy alone (13%) and chemoradiation alone (29%). Radiologic complete or partial response occurred in 33% and progression in 25%. Complete macroscopic surgical resection was achieved in 50%, and R0 resection in 38%. At median follow-up of 15 months, the 1-year and 2-year overall survival was 75% and 63% respectively, and the 1-year and 2-year progression-free survival was 50% and 29% respectively. Significant predictors of macroscopic resectability were radiologic response (p = 0.005) but not addition of radiotherapy to chemotherapy (OR 0.87, p = 0.81). Predictors of overall survival included baseline Ca19.9 level (p = 0.04) and a trend to the use of systemic chemotherapy (HR 0.51, p = 0.07), but not use of radiotherapy (HR 0.70, p = 0.47). Conclusion: There is high variability in staging and neoadjuvant approaches for borderline resectable pancreas cancer. Despite aggressive neoadjuvant therapies, R0 resection and prolonged survival are uncommon. The incremental benefit of neoadjuvant radiotherapy after neoadjuvant chemotherapy was not demonstrated in this observational study.

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Background: It is important for advanced cancer patients to understand their prognosis. This allows patients to plan appropriately for end-of-life. Unfortunately, many patients do not understand their life expectancy, often overestimating their likely survival time. Estimating survival in metastatic melanoma is particularly difficult, as immunotherapy and targeted therapies extend survival time and revolutionize care. We have previously shown that three survival scenarios (worst-case, typical, best-case), calculated using simple multiples of median overall survival ([OS], 0.25x, 0.5-2x, 3x, respectively), is a useful framework to estimate and communicate survival time to advanced cancer patients. Methods: This study aimed to determine whether three survival scenarios accurately estimate prognosis for metastatic melanoma patients receiving immunotherapy or targeted therapy. We searched Medline, EMBASE, and Cochrane Central Register of Controlled Trials for phase II/III randomized controlled trials (treatment arms n ≥90) of patients with unresectable stage IIIC/IV cutaneous melanoma receiving immunotherapy or targeted therapy from January 2001 to February 2022. We extracted OS data from Kaplan Meier curves and compared it to our multiples of median OS. Results: 26 trials (12,345 patients) were included. Our estimates of worst-case scenarios ranged from 3.29 (interquartile range [IQR] 2.82-3.76) to 6.82 (IQR 4.48-18.93) months; most-likely lower-typical from 6.57 (IQR 5.64-7.52) to 13.64 (IQR 8.96-18.93) and upper-typical from 26.28 (IQR 22.58-30.07) to 54.55 (IQR 35.83-75.73) months; and best-case from 39.43 (IQR 33.87-45.11) to 81.83 (IQR 53.74-113.60) months, among patients receiving first-line targeted and immunotherapy, respectively. Our multiples of the median OS accurately estimated survival from anywhere between 16.7% to 100% of estimates. Our scenarios tended to be more accurate for those receiving targeted (most between 70% to 100% accuracy) than immunotherapy (some as low as 16.7%); and second- (all between 50% to 100%) than first-line (some as low as 16.7%) treatment. We were unable to estimate scenarios for patients receiving first-line combination immunotherapy, as none of the treatment arms in this group met median OS. When we were inaccurate, we tended to overestimate survival. Conclusions: This study was limited by small sample sizes and immature data. The accuracy of our scenarios was more variable than previous work done by our team. Future research should include mature data and novel interventions when determining frameworks to communicate survival in metastatic melanoma. Citation Format: Megan Smith-Uffen, John Park, Andrew Parsonson, Anuradha Vasista. Estimating scenarios for survival time in patients with metastatic melanoma receiving immunotherapy or targeted therapy [abstract]. In: Proceedings of the AACR Special Conference: Tumor Immunology and Immunotherapy; 2022 Oct 21-24; Boston, MA. Philadelphia (PA): AACR; Cancer Immunol Res 2022;10(12 Suppl):Abstract nr A03.