Closing the Gap Between Tumor Board Recommendations and Liver Cancer Care

At The Liver Meeting 2026, Pierre Gholam, MD, explained why liver tumor board plans often break down at implementation and how navigators can help. In an interview with CancerNetwork® at The Liver Meeting® 2026, Pierre Gholam, MD, professor of medicine at Case Western Reserve University School of Medicine and director of the Multidisciplinary Hepatobiliary Tumor Board at University Hospitals Cleveland, discussed why patients evaluated by multidisciplinary tumor boards may not receive the recommended treatment for their liver cancer.

Gholam, who co-led a Meet-the-Expert session on next-generation multidisciplinary liver tumor boards for hepatobiliary malignancies at the meeting, noted that tumor board recommendations are nonbinding but that treating physicians rarely depart from them. Instead, he said, plans of care more often break down at implementation, when appointments with multiple providers and additional procedures such as imaging can fall through the cracks, leading to incomplete or delayed treatment.

He described a dedicated tumor board navigator as the only sure way to carry out these plans efficiently. Transcript: CancerNetwork: Many patients evaluated by tumor boards never receive the recommended treatment for their liver cancer. What drives that gap, and how can nurse navigators, pharmacists, and social workers help close it?

Gholam: It is important to remember that tumor board recommendations are, by definition, nonbinding. They are not binding on the physician presenting the case, who takes ownership of the plan of care, so that physician may or may not choose to pursue the plan as outlined by the tumor board.

In my experience of almost 15 to 16 years leading a tumor board, that is the road less traveled. Usually, people follow the tumor board’s recommendations to a T, and this is not a widespread issue. What more frequently happens is that the plan of care breaks down at the implementation phase.

Unless a navigator is present and takes ownership of the plan, including scheduling the patient with various providers and scheduling any additional procedures, such as additional chest or abdominal imaging or a PET scan, these steps might fall through the cracks. The patient may not end up receiving the full plan of care as the tumor board outlined it, or they might receive it, but with a delay.

There is no easy solution. A tumor board navigator is a critical piece of this and the only sure solution to make this happen efficiently. Reference Ilyas SI, Gholam PM.

MTE #25: next generation multidisciplinary liver tumor boards for hepatobiliary malignancies. Presented at: The Liver Meeting 2026; November 5-9, 2026; Denver, CO. Related to this article