Novel virtual pilot consultation program with intake medical oncologist to rapidly evaluate patients with metastatic gastrointestinal (GI) cancers.

200 Background: Many patients requesting evaluation at our institution are already established with a local medical oncologist. This study evaluates a novel pilot program to streamline the screening of patients with a metastatic cancer of gastrointestinal (GI) origin with a virtual intake senior medical oncologist to determine which patients would benefit from receiving further care at our cancer center. Methods: A virtual clinic separate from the institution’s GI Clinic was set up to screen patients with non-neuroendocrine metastatic disease requesting consultation for a second opinion or clinical trial. The template was designed for 2 full days of zoom consults, with maximum of 6 new patients per day, who had extensive prior treatment. At the appointment, the senior medical oncologist would discuss his recommendations and query what the patient prioritizes from our institutional evaluation. For patients interested in transferring care either completely or collaboratively, an appropriate treatment team based on disease site was then chosen and updated. The GI Advanced Practice Professional (APP) leading this initiative then placed orders to ensure that the treatment team would have the studies recommended by the intake physician. For patients interested in clinical trials, our institution’s clinical trial office was contacted to screen the patient further. Results: During the 01/07-04/23/25 period, 99 patients were seen with a median of seven days from intake to appointment. Of the patients seen, 98% were already established with an outside medical oncologist, 13% fully transferred their care to our institution, 34% opted for a collaborative approach between our institution and their local medical oncologist, 42% were not retained, 6% were enrolled or waitlisted for a clinical trial, 4% enrolled in hospice, and 1% were undecided. After intake evaluation, 28% expressed enough interest to screen for clinical trials; 7% of interested patients were enrolled in an available trial, 14% were waitlisted, and no trial was available for 79%. The majority of patients had metastatic colon (58%) or pancreas (31%) cancer and were self-referred (62%). The intake physician received high patient satisfaction scores with a Likelihood to Recommend score of 92.4. Conclusions: This virtual second opinion clinic facilitated rapid medical evaluation at our institution without interrupting the workflow of the on-site clinics and showed that greater than one third of patients opted not to return for further care. Our results also show significant discordance in clinical trial alignment, suggesting improved tailoring of available trials to our largely self-referred GI population is needed. The virtual only approach was highly regarded by our patient population and may be a sustainable way for rapid evaluation while minimizing departmental resources.