Real-world practice patterns in multidisciplinary squamous cell carcinoma care at community oncology centers.

Abstract

261 Background: As the incidence of cutaneous squamous cell carcinoma (cSCC) continues to rise and newer systemic therapies become available, coordination of care between dermatologists and oncologists will be vital to provide quality, patient-centered care. Methods: Between 8/17/2020 and 11/30/2020, we surveyed dermatology team members (n = 50) and oncology team members (n = 54) at 5 community oncology practices to assess current practices, challenges/barriers, and areas for improvement in multidisciplinary care of cSCC. Providers then participated in audit/feedback educational sessions and developed action plans to address identified gaps. Results: A majority of providers (72%) reported “very low” or “low” levels of care coordination between oncology and dermatology teams (5-point Likert scale). The three main barriers identified by dermatology/oncology teams included lack of relationship to other specialties (36%/47%), lack of multidisciplinary tumor board (30%/36%), and difficulty with patient navigation to follow-up and monitoring (44%/29%). In addition, lack of administrative support (30%/47%), lack of time (54%/42%), and high case load (32%/16%) hindered multidisciplinary tumor board meetings. Overall, dermatology teams reported lower confidence in making treatment decisions for patients with advanced cSCC compared to oncology teams. Specific strategies were identified to bridge these gaps and improve cSCC care including improving electronic communication, coordinating treatment plans with multidisciplinary teams, integrating educational seminars between oncologists and dermatologists, and finding better multimodality therapeutic options. Conclusions: These findings reveal important challenges in multidisciplinary care of cSCC in community oncology clinics. The identified gaps may inform future implementation science initiatives, and represent key opportunities for improvement in cSCC patient care.[Table: see text]

Incorporation of the 40-Gene Expression Profile (40-GEP) Test to Improve Treatment Decisions in High-Risk Cutaneous Squamous Cell Carcinoma (cSCC) Patients: Case Series and Algorithm

“…This study highlights the gap and significant challenges in the multidisciplinary treatment of cSCC in community oncology clinics. 54 A benefit to the personalized test results provided by the 40-GEP is that it can be utilized to provide a common platform to initiate MDTBs to guide risk-aligned treatment plans, regardless of the specialty or staging systems used. The 40-GEP test has been shown to accurately categorize the risk of metastasis in patients with cSCC who have one or more risk factors and gives prognostic information independent of recognized high-risk factors or conventional staging systems.…”

“…This study highlights the gap and significant challenges in the multidisciplinary treatment of cSCC in community oncology clinics. 54 A benefit to the personalized test results provided by the 40-GEP is that it can be utilized to provide a common platform to initiate MDTBs to guide risk-aligned treatment plans, regardless of the specialty or staging systems used.…”