A multidisciplinary approach is advocated for optimal management of stage III/IV non-small cell lung cancer (NSCLC). Thoracic surgeons (TSs) and radiation oncologists (ROs) are critical members of a NSCLC multidisciplinary clinic (MDC), but data on specialty perceptions and practice patterns are limited. This survey assessed the role of TSs and ROs in NSCLC care delivery and identified barriers for ideal NSCLC patient management. A double-blind, web-based national survey of multidisciplinary specialists, including TSs, ROs, medical oncologists (MOs), and pulmonologists, was conducted between January and April 2019 to obtain insights on care of patients with advanced NSCLC across several U.S. community cancer programs. In total, 639 respondents from 160 unique cancer programs in 44 U.S. states completed the survey: 11.3% (72/639) were TSs and 17.8% (114/639) were ROs. TSs were more likely to define the presence of a suspected mediastinal node metastasis as unresectable vs other specialties (p = 0.005). Programs with an MDC were more likely to have clear definitions of unresectable tumors vs cancer programs without an MDC; MDCs presence positively correlated with the use of a stage III NSCLC tumor resection protocol (p = 0.034). ROs significantly differed in their perception of treating patients with stage III unresectable disease with either concurrent chemoradiation or chemotherapy/radiation alone vs other specialties (p≤0.009). Of patients with stage IV disease, 5–10% refused the initial treatment prescribed by ROs (46.7%) vs other disciplines (25.8%; p = 0.003). A large proportion of MOs (49%) vs ROs (25%) were familiar with guidelines on immune-related adverse events (irAEs). Additionally, TSs and ROs significantly differed (p<0.05) in the process of assessing irAEs, indicating the absence of a standard process; MDCs presence improved use of clinical pathways (p = 0.035). ROs frequently adopted the process of shared decision-making (SDM) to tailor care plans and use decision aids, in contrast to TSs who rarely used SDM. Barriers faced by these disciplines are listed (Table). This survey highlights multiple opportunities to improve care coordination and treatment of patients with advanced NSCLC. Notably, the presence of MDCs inclusive of TSs and ROs may improve the SDM process by standardizing patient management and overall care.Abstract 2302; TableBarriers to ideal NSCLC care as perceived by TSs and ROsImpactTSsROsMinimal-Lack of patient interest in screening; cost; communication of test results to cliniciansSomePatients refuse to undergo biopsy or other testsNo coverage of and reimbursement for molecular testsSignificantPoor handling, storage, and transport of biopsy samples for biomarker testing; misinterpretation of biomarker resultsRO, radiation oncologist; TS, thoracic surgeon. Open table in a new tab