How to Implement a Multidisciplinary Team Approach to Improve NSCLC Treatment
The importance of multidisciplinary team (MDT) care coordination in the diagnosis and treatment of early-stage non-small cell lung cancer (NSCLC) was highlighted at the AVAHO 2024 annual conference by Alexander Whitley, MD, PhD, FACRO.1 He emphasized the key role that different specialists play in determining the best treatment approach for individual patients, considering factors such as staging accuracy, operability, patient preferences, and historical outcomes of lung cancer treatment. Collaboration among professionals from pathology, surgery, oncology, and other specialties is essential to ensure the best oncologic and functional outcomes for patients.
Dr. Whitley highlighted the need for a shared decision-making model with patients, especially when considering different treatment options such as surgery, radiation, or chemotherapy. For patients with stage II and stage III NSCLC, coordination of care becomes even more crucial due to the wider range of treatment options available and the varying complexities of the disease. Complete staging is essential for stage III cases, requiring input from all specialties to determine the best course of action for each patient.
"Stage III disease is that much more so a multidisciplinary approach and I would submit requires input of all specialties to coordinate the best care for the patient and the disease,” Dr Whitley said.
Utilizing an MDT in the treatment of NSCLC ensures that patients are well-informed and have the best chance at optimal outcomes, but it also allows for continuous evaluation and adjustment of treatment plans as patients progress through therapy.
“Understanding your own medical environment as a practitioner and working to limit delays in diagnosis, staging, multidisciplinary discussion, and management through the process is critical to making the changes necessary to benefit your patients, neighbors, and friends,” Dr Whitley said.
Research published in the Journal of Thoracic Oncology Clinical and Research Reports evaluated how MDTs affect overall survival and quality of care for patients with NSCLC in a comprehensive systematic review.2
A literature search strategy was applied to various databases without any time, geographic, or language restrictions. Eligibility criteria included randomized controlled trials and observational studies focusing on patients with NSCLC managed by MDTs. Data extraction, risk bias assessment, and analysis were conducted to summarize the association between MDTs and overall survival in patients with NSCLC.
The systematic review included a total of 22 studies. Of the 10 outcomes identified, the MDT group was found to be favored over the non-MDT group. Pooled analysis indicated that patients managed by MDTs had better survival, shorter treatment times, and a higher proportion of complete staging compared to the non-MDT group. These results were based on a significant number of participants across multiple studies.
“This meta-analysis revealed that MDT-based patient care was associated with longer overall survival and better quality-of-care–related outcomes,” researchers concluded.
The Improving Care Coordination (ICC) Model, developed by the Association of Community Cancer Centers (ACCC) in 2020, is the latest tool for oncology clinicians to implement when pursuing MDT-focused patient care.3 The ICC Model is built on the Multidisciplinary Care (MDC) Assessment Tool created by the National Cancer Institute’s Community Cancer Centers Program (NCCCP). The model includes 12 assessment areas and 5 levels to help cancer programs improve care coordination.
References
- Whitley A. Working together to advance guideline-recommended care for early stage NSCLC. Presented at: AVAHO 2024; September 20-22; Atlanta, GA.
- de Castro G, Hahn Souza F, Lima J, et al. Does multidisciplinary team management improve clinical outcomes in NSCLC? A systematic review with meta-analysis. JTO Clin Resp Ret. 2023;4(12):100580. doi:10.1016/j.jtocrr.2023.100580
- Meier L. Improving care coordination for patients with lung cancer: The basics. ACCC. Published November 16, 2023. Accessed November 25, 2024. https://www.accc-cancer.org/acccbuzz/blog-post-template/accc-buzz/2023/11/16/improving-care-coordination-for-lung-cancer-patients-the-basics
