Advancing TNBC care in the community oncology practice: Insights from a quality improvement initiative.

Abstract

e18762 Background: New and emerging treatments for metastatic triple negative breast cancer (mTNBC) are improving outcomes for patients. However, given the fast pace of innovation, staying informed about the latest clinical trial data, guideline recommendations, and adverse event management, is challenging, particularly in community-based settings. To improve the care of mTNBC patients, we conducted a quality improvement (QI) initiative across 10 community-based oncology practices. Methods: Between 9/7/2021 and 2/11/2022, we surveyed multidisciplinary oncology team members (N = 121) at 10 community oncology clinics to assess current practices, challenges/barriers, and areas for improvement in mTNBC care. Providers then participated in audit/feedback (AF) educational sessions (N = 150) where they (a) assessed system-specific practice gaps identified via the provider surveys, (b) prioritized areas for improvement, and (c) developed action plans for addressing root causes of the identified gaps. Results: Providers reported the top challenge in caring for patients with mTNBC as sequencing treatment options across multiple lines of therapy (33%). Providers participating in the AF sessions identified impact on overall survival (55%), molecular test results (49%), and impact on patient quality of life (44%) as their primary considerations when differentiating among new and emerging targeted therapies for mTNBC. Additionally, clinicians reported having the most difficulty managing gastrointestinal distress (31%), cardiotoxicity (31%), and endocrinopathies (31%) associated with novel therapies. Providers believed improved collaboration across interprofessional teams (32%) and increased patient education for aspects of supportive care (28%) would improve care for mTNBC patients. To address the identified gaps at each location, teams developed action plans to improve coordinated mTNBC care, provide patient-centered supportive care, increase testing for targeted therapies, improve symptom and adverse event management, and create standardized order sets. Conclusions: Through this QI initiative, clinical teams identified gaps/barriers in their own practices, and developed and implemented action plans for improvement. These data and actionable insights support safe, effective, and evidence-based integration of novel therapies into mTNBC care to optimize patient outcomes. Study Sponsor Statement: The study reported in this abstract was funded by an educational grant from Gilead Sciences, Inc., who had no role in the study design, execution, analysis, or reporting.