Feasibility Study: Early Experiences With a Cancer Center's Virtual Expert Medical Opinion Program

PURPOSE Second opinion consultations are a promising strategy to identify errors in diagnosis and recommend optimal treatment. Yet, there are geographic barriers. By bringing high-level care to patients where they live, virtual second opinion programs might benefit populations without access to specialty cancer centers. We conducted a feasibility study that examined changes in treatment recommended through a national virtual second opinion program based at a comprehensive cancer center. METHODS Memorial Sloan Kettering Cancer Center (MSK)'s virtual second opinion program was developed via a national cancer employer benefits solution. Each review was conducted by an MSK subspecialist and supported by a digital platform. After conducting the second opinion, subspecialists answered a questionnaire regarding their perceptions of the expected impact of recommended treatment changes. Here, we report findings from December 2023 to November 2024. RESULTS There were 231 cases completed. There were 55% women, with a median age of 56 years. Patients resided across the United States, with 56% from the South. The most common cancer categories were breast, GI and mixed tumor (GMT), and prostate. Cases were reviewed by 76 unique subspecialists. Subspecialists perceived that they made a meaningful change in recommended treatment (expected to affect patient outcomes) in 75 cases (32%). Expected changes included better prognosis/survival (n = 49, 65%), improved short-term morbidity/quality of life/toxicity (n = 36, 48%), or improved long-term morbidity/quality of life/toxicity (n = 49, 65%). There was a higher percent of recommended changes for liquid compared with solid tumor cases (liquid: 15 of 31, 48%; solid: 60 of 200, 30%). CONCLUSION Findings are helpful for understanding the potential impact of a virtual second opinion program for patients with cancer and for developing strategies to reach underserved communities with geographic access barriers to high-quality cancer care from subspecialists.