[Abstract #923] Understanding practices and gaps in multidisciplinary hepatocellular carcinoma (HCC) care within the community oncology setting

Philip A. Philip, MD, PhD, FRCP¹, Leigh Boehmer, PharmD, BCOP², Lorna Lucas, MS² & Christie Mangir, MS^2
1Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA; ²Association of Community Cancer Centers, Rockville, MD, USA

Background:

The Association of Community Cancer Centers (ACCC) developed a needs assessment to identify factors associated with delivery and coordination of care for HCC patients in community settings. The survey was deployed electronically in July 2018 to multidisciplinary providers, representing 17 oncology professions. Of the responses (n=31), 69% identifed their care setting as a "non-teaching community hospital, freestanding cancer center, private practice or other."

Clinical Findings/Procedure Details:

61% of respondents indicated their cancer programs do not have a specialized hepatobiliary multidisciplinary team. Among those who have hepatobiliary multidisciplinary teams the composition and degree of specialization varied. 85% of respondents that do not have a specialized hepatobiliary team indicated that HCC patients are managed in consultation with a general tumor board. 52% of respondents indicated their cancer program discussed participation in clinical trials with all HCC patients, and 55% of cancer programs conducted HCC clinical trials. 52% indicated their cancer program had a formal pathway that outlines adherence to the NCCN guidelines for HCC management, 5% were in the process of developing and 43% were not in the process of developing such a pathway. Of respondents that reported barriers their cancer program faces (n=13) 31% indicated lack of psychosocial services, lack of screening and no/limited access to clinical trials. 23% responded delayed treatment and 15% responded delayed diagnosis as challenges.

Conclusion and/or Teaching Points:

The survey reviewed multidisciplinary care delivery for HCC patient populations and revealed unique protocols and associated challenges within primarily community-based settings.