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e24127 Background: Patients with a rare cancer (RC) diagnosis face unique challenges affecting psychological wellbeing. Vast geographical distances further compound challenges in accessing RC sub-specialist expertise, clinical trials, research and non-reimbursed therapies. The Australian Rare Cancer (ARC) Portal is a novel model of care delivery that has a positive psychological impact on these patients. Methods: The ARC Portal is a national free online referral platform implemented to overcome barriers to accessing excellent care. It is funded by Omico, with support from BioGrid Australia, Rare Cancers Australia (RCA), and The WEHI Stafford Fox Rare Cancer Program (SFRCP). We have recorded 924 referrals for a diverse range of RC in early (30%) and late stages (70%). Our 162 referring clinicians derive from every Australian state and from both regional and metropolitan centres. Over 50 content experts from Australia and internationally have provided case advice. Referring clinical impact surveys and patient feedback surveys were analysed to identify psychosocial impacts of the ARC Portal. Results: Our model of care keeps patients with their primary oncologists by equipping referrers with increased expertise drawing from, on average, two to five experts. The entirely online consent process overcomes geographical barriers to enrolment, and is of particular importance in the context of the ongoing COVID-19 restrictions removing in person interaction. Provision of expertise and treatment recommendations meets informational needs and increased the patient confidence patients in their treating clinicians. Report recommendations directly altered the treatment delivered to patients in 20/48 of surveyed referrer respondents. Early stage patients are eligible for referral to guide neoadjuvant and adjuvant therapy, and those in remission for anticipatory identification of next lines of therapy. We identify appropriate access to investigator-driven research efforts to overcome financial barriers to genomic sequencing e.g. via the MoST Program funded by OMICO and the WEHI-SFRCP enabling access to molecularly-guided therapy. A lack of reimbursed therapeutic options in RC poses financial stress on patients. The ARC Portal expands patients’ treatment options via links with clinical trial networks, coordination with industry, and cross-referral to the charity, RCA, for fundraising assistance. We provide patients with the opportunity for involvement in research, which for many provides hope, either for themselves, or for others, as they can opt to provide access to biomarker and tumour specimens via the WEHI-SFRCP; the majority of patients (82.5%) have provided consent. Conclusions: The ARC Portal offers patients access to excellent rare cancer care resulting in positive impacts upon patients’ psychological wellbeing. These initial observations require more formal assessment.

e18581 Background: Rare cancers (RC) occur at incidence < 6/100,000 and accessing treatment and evidence-based care can be challenging. Australia’s geographical distance adds complexity when referring to RC sub-specialists, clinical trials or research. The Australian Rare Cancer (ARC) Portal aims to address this unmet need. Methods: The ARC Portal is a free online academic referral hub designed to facilitate rare cancer clinical care and research. Registered cancer specialists can request RC guidelines, expert advice and molecular testing/interpretation. Patient consent allows researchers access to de-identified clinical data, with optional consent for biospecimen access, for dedicated rare cancer research projects (Melbourne Health HREC/15/MH/396). Portal case reports are collated by research fellows with reference to published evidence and expert opinion to inform treating clinician decision making. Surveys are sent at 3 time points following case completion to assess the ARC Portal impact on patient management. The ARC Portal is funded by Omico, with support from BioGrid Australia, Rare Cancers Australia and the Stafford Fox Rare Cancer Program. Results: Over two years, 924 patients have been enrolled into the ARC Portal. Demographics include 73% females, 27% males, at different disease stages from initial diagnosis (23%), on relapse/ progression (48%) or with stable disease/in remission (29%). The spread of incidence of individual cancers varied from 6/100,000 to < 0.1/100,000. Primary tumour types include gynaecological (44.4%), gastrointestinal (19%), thoracic (6%), ocular (5.2%), soft tissue (3.8%), breast (3.6%), skin (3.0%), and CNS tumors (2.5%). Endocrine, head and neck, urological, and cancers of unknown primary comprised the remaining 12.5% of cases. Longer term follow up of 100 cases demonstrated ARC Portal reports impacted clinician decision making in at least 42%. This included subsequent lines of treatment, molecular testing access or clinical trial enrolment. Conclusions: The ARC Portal uses an online centralized streamlined approach to overcome challenges and inequities inherent in rare cancer care, by optimizing clinician access to RC expertise and clinical trials; and to facilitate future RC discoveries by enabling research through collection of clinical data and accessible annotated biospecimens.