Abstract 5775: Survey to identify current physician preferences for the treatment of patients with desmoid tumors

Abstract

Abstract Purpose: The purpose of this survey was to identify the specialties of physicians who treat patients with desmoid tumors and their current treatment preferences. Methods: There is currently no dedicated ICD-10 code for desmoid tumors, rendering the identification of physicians who treat these patients and the therapies used challenging. An invitation to participate in a survey regarding the treatment of desmoid tumors was distributed to 38,539 U.S. physicians in the Olson Research Group database. Only physicians who reported having treated ≥5 such patients during the preceding 5 years in a pre-screening questionnaire were invited to complete the online survey. Results: A total of 203 respondents completed the survey, including 46 medical oncologists, 35 surgical oncologists, 29 hematologist-oncologists, 26 orthopedic surgeons, 22 general surgeons, 17 plastic surgeons, 13 radiation oncologists, 8 interventional radiologists, and 7 other specialists. Physicians were presented with three patient profiles and asked to select the front-line and second-line treatments they were most likely to recommend for the patient. In Profile A, the patient presented with a germline APC mutation and a mesentery desmoid tumor progressing radiographically. In Profile B, the patient presented with an extremity desmoid tumor progressing radiographically but that resulted in little-to-no pain or range-of-motion impairment. In Profile C, the patient presented with a desmoid tumor that remained stable radiographically for ≥12 months but that was causing moderate-to-severe pain. Physicians were provided with six potential treatment options: locoregional therapy, including surgical interventions, tyrosine kinase inhibitors, chemotherapeutic agents, watchful waiting, other systemic therapies, and referral to another specialist. Locoregional therapy was the most frequently preferred front-line intervention, and tyrosine kinase inhibitors were the second most frequently preferred front-line intervention. Tyrosine kinase inhibitors were the most frequently preferred second-line intervention. Conclusions: While locoregional therapies remained the most frequently preferred front-line therapy among the cohort of 203 U.S. physicians surveyed, systemic therapies accounted for >50% of preferred front-line therapies in patients with mesentery desmoid tumors and >50% of preferred second-line therapies for all patient profiles presented. Table 1:Physician Front-Line and Second-Line Treatment Preferences for Three Patient ProfilesPatient Profile APatient Profile BPatient Profile CAPC GermlineProgressing, asymptomaticNon-progressing, symptomaticFront-LineSecond-LineFront-LineSecond-LineFront-LineSecond-LineLocoregional therapy35%18%47%27%49%23%Tyrosine kinase inhibitor30%43%21%41%22%41%Chemotherapy19%23%11%20%11%20%Watchful waiting5%1%14%2%7%0%Other systemic therapy3%4%3%3%5%4%Refer to another specialist6%11%3%7%5%11% Citation Format: Jessica White, Badreddin Edris, Jens Renstrup, L. Mary Smith, Brad Tumminello. Survey to identify current physician preferences for the treatment of patients with desmoid tumors [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 5775.