Transcript: Making management decisions within multidisciplinary teams
Axel Merseburger, MD, PhD
All transcripts are created from interview footage and directly reflect the content of the interview at the time. The content is that of the speaker and is not adjusted by Medthority.
There are multiple factors, and very important factors, that influence the management decision within the MDT. First of all, it depends on who's running the MDT. Is it really multidisciplinary? That is mandatory, because of the name and because of the nature. You need to have multiple disciplines to have this tumor boards who have this discussion ongoing. And in prostate cancer, definitely urologists, medical oncologists, radiation oncologists, best also, pathologists, when you think of like genetic alterations that play an important role in how we treat prostate cancer nowadays and how we will treat in the future. And also genetics, radiation, oncologist I've mentioned, and also radiologists is important.
We also include the study nurses from our team. Then when it comes to patient factors, it is important to look at the age, comorbidities, the disease stage, if it's non-metastatic, nmHSPC in prostate cancer, or if it's metastatic hormone-sensitive prostate cancer. Here, the modern imaging with PSMA PET really, really plays an important role and has replaced, in this situation, the conventional imaging in a lot of countries and MDTs. Then, as said, I think it's important that there's somebody that knows the patient, knows the patient characteristics, the quality of life, and what is important for the patient. Sometimes the treating doctor says, "Hey, this patient does not want chemotherapy." So that is important for further planning.
So I think it is very important to have somebody in the MDT that knows the patient, the patient preferences. And in some countries, and a lot of countries worldwide, also availability of drugs, differences between the areas, the rural or urban areas, with regards to application routes, if it's subcutaneous, if it's a tablet, if it's IV. And also, the cost plays a role in reimbursement, depending on the local situation and the national reimbursement situation. So, it is very important to have a very individualized assessment to determine the most appropriate management approach and have also the best doctors, the best MDT from the clinic. It should not be junior show, juniors are welcome to join, and they have to be there because of the educational purpose of this whole MDT. But for getting the best result in an MDT, the experts from each specialty should join this MDT. And it's always a Wednesday here in my institution where we all meet with all the chairmens and chairladies of the departments and discuss those cases. Still online since the pandemic, because this saves time, and we have the pictures, the imaging, right in front of us, and if needed, can also access the electronic file easily. So, thank you for this attention. I think it is very important that we have key factors that needs to be taken into account when a decision is made in an MDT.
This educational program has been developed by EPG Health in partnership with the sponsor, Astellas. Indications and availability of products discussed in this educational program may vary in different countries. Please refer to the local summary of product characteristics / prescribing information for details. Astellas prohibits the promotion of unapproved uses and complies with all applicable laws, regulations, and company policies. In expert interviews, podcasts, and panel discussions, the views, thoughts, and opinions expressed belong solely to the speaker(s) and are subject to change without notice. This content is intended for healthcare professionals (HCPs) only. Non-HCPs should not view this educational program and should exit the program as soon as possible.
MA-MM-16216, August 2025.