Impact of technology-based access to a multidisciplinary tumor board on treatment planning for patients with cancer in developing countries.

Abstract

271 Background: The developing countries account for 70% of cancer associated mortality in spite of significantly lesser incidence than the developed world. The main reason for poor outcomes is acute shortage of trained oncology medical professionals. We conducted a prospective study on impact of Onco.com multidisciplinary tumour board (MTB) opinion on the treatment plan for patients. Onco.com provides online access to senior experts in oncology from India and United States wherein the patients can avail unbiased, evidence based treatment opinion through technology. Methods: We prospectively evaluated the impact of treatment plan provided by multidisciplinary team of oncologists on the treatment received by patients who opted for secure online opinion on onco.com. A total of 335 patients from 13 countries received online MTB opinion from July 2017 till April 2018 were included in the study. A multidisciplinary tumour board was constituted through an automated system by matching expertise of the oncologists as per patient’s condition. The experts had access to cutting edge scientific journals and international clinical practice guidelines (NCCN, ESMO, Uptodate.com) while giving opinion for the patient. The opinion was delivered in 3 days. Results: Of the total 335 MTB reports evaluated, 68 had stage I or II disease, 104 had locally advanced disease and 163 patients had metastatic/relapsed disease at presentation. Online access to multidisciplinary team of expert oncologists lead to a better treatment plan for 81.5% patients, while significant 14.6% patients received drastic changes in their existing treatment plan. Conclusions: The results demonstrate that technology can help us bridge the gaps in access to trained expert oncologists across borders for developing countries and help them receive better treatments. A longer follow up is needed to evaluate impact of online MTB opinion on clinical outcomes for patients.[Table: see text]