Physician tumor board participation linked to clinical trial enrollment
Patients with lung or colorectal cancers whose physicians attended weekly multidisciplinary tumor board meetings were more likely to enroll in clinical trials, according to study results presented at the ASCO Quality Care Symposium.
“Prior studies have been conflicting with regard to the impact of tumor board meetings on patient care,” researcher Kenneth L. Kehl, a fellow in cancer medicine at The University of Texas MD Anderson Cancer Center, said during a press conference. “Our first objective in this analysis was to characterize overall tumor board participation patterns among physicians caring for recently diagnosed lung and colorectal cancer patients. Secondly, we assessed for associations between tumor boards and patient clinical outcomes, adjusting for as many clinical and demographic confounders as possible to try to isolate the independent effect of tumor boards.”
Kehl and colleagues surveyed 1,601 community- and institution-based physicians about their participation in tumor board meetings — which involve surgeons, medical oncologists and radiation oncologists — and about the purpose and scope of the meetings.
Researchers also surveyed 4,620 of these physicians’ patients with lung or colorectal cancers about their communication with their oncology care providers.
Overall, 96% of physicians reported routine participation in tumor board meetings, and 54% reported weekly participation.
Most meetings (82%) were focused on pre-treatment planning, and 92% included an evaluation of prior treatment decisions. Twelve percent of the meetings included teaching sessions rather than a discussion of individual patient cases.
Results also showed 87% of meetings reviewed a variety of cancer types, and 59% focused only on the physicians’ challenging cases.
Overall, weekly tumor board participation was significantly associated with clinical trial enrollment among patients (OR=1.6; 95% CI, 1.1-2.2).
Patients with stage I to stage II non–small cell lung cancer were more likely to undergo curative-intent surgery if their physicians attended tumor board meetings weekly (P˂.001), but this association did not persist if the tumor boards reviewed a variety of cancer sites.
Patients with extensive-stage small cell lung cancer (SCLC) or stage IV colorectal cancer demonstrated improved survival when their physician participated weekly in tumor board meetings compared with patients whose physicians participated less often (P˂.05). Yet, tumor board meetings that only served as teaching sessions were associated with worse survival in patients with SCLC who had limited (P=.004) or extensive (P˂.001) disease.
However, these survival findings are not definitive, Kehl said.
“By definition, since this is an observational analysis and since we used a statistical model trying to isolate the effect of tumor boards, I think it would be hard to definitively say that these meetings directly impacted survival for these patients,” Kehl said. “This finding merits exploration, but in any analysis like this, you cannot draw a direct cause-and-effect relationship.”
For more information:
Kehl KL. Abstract #179. Scheduled for presentation at: ASCO Quality Care Symposium; Oct. 17-18, 2014; Boston.
Disclosure: The researchers report no relevant financial disclosures.