243 - From Data to Dialogue: A Real-Time Digital Platform Accelerates Multidisciplinary Decisions in Bone Metastases

Purpose/Objective(s):

For patients with bone metastases, multidisciplinary consensus is important, however traditional weekly tumor boards often create treatment bottlenecks. In advanced cancer care, delays in radiation can lead to clinical consequences. We developed NIMBLE (Network for the Integrated Management of Bone Metastases: Linking Experts), a secure digital platform enabling real-time specialist communication. In this study, we hypothesized that replacing traditional tumor board workflows with immediate, coordinated digital communication would expedite clinical decision-making and optimize treatment delivery.

Materials/Methods:

From September 2023 to April 2024, 127 consecutive patients were referred to a newly established bone metastasis program. Eighty-one percent were managed using NIMBLE, while 19% were discussed through traditional weekly tumor board workflows. Comparisons of time to recommendation, time to consultation, time to treatment initiation, and management strategy between cohorts were made.

Results:

Baseline demographic and tumor characteristics were comparable between groups (Table 1).

Median time from intake to multidisciplinary treatment recommendation was dramatically reduced with NIMBLE (1.9 vs. 24 hours, p < 0.0001). Time from intake to radiation consultation was also significantly shorter (8 vs. 18 days, p = 0.02), with a clinically meaningful trend toward earlier treatment initiation (22 vs. 38 days, p = 0.12). Notably, conservative management was recommended more frequently in the NIMBLE cohort (67% vs. 33%, p = 0.005), suggesting improved triage efficiency and avoidance of unnecessary radiation.

Conclusion: A structured digital communication platform converted multidisciplinary input from a weekly discussion into a same-day multidisciplinary discussion, reducing decision time by over 90%. These findings demonstrate that operational innovation can accelerate advanced cancer care in radiation and optimize resources. NIMBLE demonstrates how radiotherapy programs can leverage real-time data exchange to enhance value, efficiency, and patient-centered decision-making.

Abstract 243 - Table 1: Patient and Tumor Characteristics

Table 1: Patient and tumor characteristics

	NIMBLE Communication (N=102)	Standard Weekly Tumor Board (N=25)	p-value
Age	65	68	0.81
Gender	Male: 53% Female 47%	Male: 46% Female: 54%	0.23
KPS	=80: 84%	=80: 81%	0.66
Histology	Adenocarcinoma: 67% RCC: 10% Myeloma: 5% Neuroendocrine: 3% SCC: 7% Other: 8%	Adenocarcinoma: 72% RCC: 8% Myeloma: 0% Neuroendocrine: 4% SCC: 16% Other: 0%	0.35
Primary Site	Prostate: 18% Breast: 22% Lung: 16% GI: 13% Kidney: 11% Other: 20%	Prostate: 28% Breast: 12% Lung: 24% GI: 8% Kidney: 8% Other: 20%	0.58
Location of Bone Metastasis	Pelvis: 54% Femur: 25% Other: 21%	Pelvis: 68% Femur: 16% Other: 16%	0.43
Fracture?	None: 82% Path: 14% Impending: 4%	None: 76% Path: 16% Impending: 8%	0.64