Predictors of Multidisciplinary Tumor Board Adherence in Stage III Non-Small-Cell Lung Cancer Patients From a Large...

Area of Science:

• Oncology
• Clinical Cancer Research
• Thoracic Oncology

Background:

• Multidisciplinary tumor board (MDT) recommendations are standard for non-small cell lung cancer (NSCLC) treatment.
• Previous studies link MDT to improved patient care and survival.
• Prognostic impact of individual adherence to initial MDT recommendations in stage III NSCLC is unknown.

Purpose of the Study:

• To evaluate the prognostic impact of adherence to initial MDT treatment recommendations in stage III NSCLC patients.
• To identify factors associated with MDT non-adherence.

Main Methods:

• Retrospective analysis of multimodal treatment data from 3 Swiss referral centers (2014-2020).
• MDT adherence defined as implementation of recommended modalities and sequence.
• Kaplan-Meier analysis for event-free survival (EFS) and overall survival (OS); multivariable Cox regression for MDT adherence.

Main Results:

• 70.4% of 547 eligible patients adhered to initial MDT recommendations.
• Non-adherence (16.3% received non-curative treatment) was associated with treatment de-escalation.
• Increased risk of non-adherence observed in patients ≥ 65 years, higher tumor stage, and ECOG ≥ 2 (frail patients).
• MDT-adherent patients had significantly higher median EFS (11.9 vs. 8.6 months) and OS (20.3 vs. 9.4 months).

Conclusions:

• Approximately one-third of stage III NSCLC patients do not adhere to initial MDT recommendations.
• Non-adherence to MDT recommendations is associated with significantly worse survival outcomes.
• Treatment strategies for vulnerable patient populations require critical review and optimization.