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109 Understanding current multidisciplinary team structures and management practices for advanced ovarian cancer in the UK: the KNOW-OC survey
  1. C Fotopoulou1,
  2. C Gourley2,
  3. J Ledermann3,
  4. M Hall4,
  5. J Ayub5,
  6. L Fildes5,
  7. N Roebuck5,
  8. R Lord6,
  9. R Miller7 and
  10. S Sundar8
  1. 1Hammersmith Hospital, London, UK
  2. 2Cancer Research UK Edinburgh Centre, Edinburgh, UK
  3. 3UCL Cancer Institute and UCL Hospitals, London, UK
  4. 4Mount Vernon Cancer Centre, Northwood, UK
  5. 5GSK UK Ltd, Brentford, UK
  6. 6Clatterbridge Cancer Centre – Liverpool, Liverpool, UK
  7. 7University College London, London, UK
  8. 8University of Birmingham, Birmingham, UK


Introduction/Background*With increasing availability of multi-modality treatment options for advanced ovarian cancer, the role of the multidisciplinary team (MDT) is key. Here, we aim to understand MDT structures and management practices relating to first line (1st-line) systemic treatment for advanced ovarian cancer in the UK.

Methodology Structured telephone interviews about current MDT composition and treatment practices in alignment with European (ESMO/ESGO) consensus recommendations for advanced ovarian cancer were conducted in October/November 2020 with 66 healthcare professionals (HCPs) involved in the secondary care of ovarian cancer across the UK (48.5% from specialist cancer centres).

Result(s)*Figure 1 and table 1 summarise the staff members regularly attending MDTs and responsibilities across the pathway. While the MDT reviewed 1st-line treatment options according to 98.5% of HCPs; only 66.7% and 40.9% said MDTs reviewed treatment after first or second relapse. Before planning 1st-line treatment, CA-125 (98.5%), gBRCA (n=81.5%) and tBRCA (76.9%) were the biomarkers most commonly assessed. 90.6% (n=58/64) of HCPs considered gBRCA/tBRCA results to be the most important determinant of prognosis. HRD was the second most important biomarker (55.9%; n=33/59), however, only three HCPs reported routine assessment. The estimated proportion of patients (median [IQR]; n=54) currently treated with 1st-line maintenance strategies was: 50% [26.3-65.0%] active surveillance; 20.0% [11.3-33.8%] bevacizumab and 15%[10.0-30.0%] PARP inhibitor (PARPi). Anticipated future eligibility (n=55) was: 35.0% [22.5-50.0%]) PARPi maintenance monotherapy; 15.0% [7.5-30.0%] combination PARPi/bevacizumab; 20.0% [10.0-32.5%] active surveillance; 10.0% [8.5-20.0] bevacizumab alone.

Abstract 109 Figure 1

Responses to question: ”which specialties regularly (≥80% of time) attend the MDT?”

Abstract 109 Table 1

Responses to question: ”Who has overall responsible for the clinical management of patients at each stage in the patient pathway?“ (N=66)

Conclusion*The level of MDT involvement in the non-surgical management of advanced ovarian cancer varied depending on pathway and line of relapse. While almost all patients had input from an MDT at initial presentation, less than half of the patients were discussed at an MDT when they experienced subsequent relapses indicating reduced access to a multidisciplinary care. BRCA mutation status was considered the most important biomarker. Whilst HRD status was also considered important, at the time of the survey this was not routinely assessed, highlighting issues with test availability. The use of active surveillance was expected to decrease in favour of targeted therapies such as PARPi as the treatment pathway evolves.

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