Evaluation of a co-designed nurse-led geriatric oncology multidisciplinary model in treatment-naive older adults with solid cancers.

1661 Background: Integration of geriatric assessment into cancer care improves outcomes for older adults but remains limited by resource intensity and reliance on physician time, hence restricting scalability. We evaluated the implementation of a co-created multidisciplinary (MDT) nurse-led geriatric oncology (GO) model developed to address these barriers. Methods: Implementation evaluation was conducted across two tertiary cancer centers. Older adults (≥65 years) with solid cancers underwent nurse-led structured geriatric assessment and MDT review involving medical oncology and geriatric medicine prior to oncology consultation. MDT recommendations addressed identified vulnerabilities, with referral for geriatrician-led CGA reserved for complex cases. Outcomes included G8 screening, referral for CGA, SACT delivery, treatment modification due to frailty, treatment discontinuation, delays, dose modification due to toxicity, and health service utilization (ED, SURC and unplanned hospital admissions within 12 weeks). Demographic and clinical characteristics were summarized using descriptive statistics. Associations with health service use were determined using logistic regression analyses. Results: Of 431 eligible pts, 204 (47.3%) participated in the GO assessment. Median age was 76 years. Most pts had lung cancer (73.1%), followed by GU (14.8%) and upper GI cancers (8.6%). Disease stage did not differ between groups; GO pts were more likely to have ECOG PS 1–2 and 81.4% scored ≤14 on the G8 screening tool. Half (50.7%) were referred for CGA and 67.1% of this cohort received SACT while 32.4% of the cohort not referred for a CGA received SACT. Upfront treatment modification due to frailty was numerically higher in GO pts compared to non-participants (21.1% vs 13.1%, p=0.076). GO participation was associated with higher receipt of SACT (70.6% vs 59.7%, p=0.019), increased use of monotherapy (22.5% vs 13.7%, p=0.016), and lower rates of BSC alone (41.0% vs 59.0%, p=0.033). There were no differences between groups in treatment discontinuation (p=0.64), delays (p=0.074), or dose modifications due to toxicity (p=0.42). GO pts were more likely to be admitted to hospital within 12 weeks of initial oncology consultation. Conclusions: GO assessment supported detailed evaluation of older pts with borderline ECOG PS and increased access to SACT, particularly monotherapy, without increasing treatment-related toxicity. Higher hospitalization rates likely reflect appropriate escalation of care following identification of frailty-related needs. GO vs no GO. GO (n=204) No GO (n=227) p-value Age median (range) 76.0 (72.0, 81.0) 76.0 (71.0, 81.0) 0.77 Monotherapy 46 (22.5%) 31 (13.7%) 0.016 Doublet, or more therapy 98 (48%) 101 (44.5%) 0.46 ED presentation 93 (45.6%) 86 (37.9%) 0.11 SURC use 43 (21.1%) 49 (21.6%) 0.90 Inpatient admission 74 (36.3%) 62 (27.3%) 0.046