Contemporary management of patients with advanced melanoma: Utility of an online interactive decision support tool to assess concordance of healthcare professional treatment patterns with expert recommendations.

Abstract

e13548 Background: The treatment landscape for patients with melanoma continues to evolve with approvals of novel therapeutic agents for advanced disease and new indications for therapy in earlier-stage disease. Using an online decision support tool, we compared practice patterns and treatment recommendations between community healthcare professionals (HCPs) and key opinion leaders (KOLs). Methods: The online decision support tool was developed with input from 5 KOLs who provided treatment recommendations for 151 hypothetical patients. Case scenarios covered a spectrum of stages (III, IV), central nervous system (CNS) metastases, BRAF mutation status, and treatment histories. HCPs entered specific patient criteria into the tool to define a case and their intended therapy choice and the tool then showed 5 KOL recommendations for that patient case. An analysis of KOL recommendations and HCP-selected therapy was performed. Results: Between August 2023 and January 2024, 156 patient cases were entered by 100 HCPs. HCP and KOL recommendations were concordant in 51% (80/156) of cases. The highest level of discord among HCPs and KOLs was 72% for patients with completely resected stage IIIA melanoma and no positive lymph nodes having a metastatic focus ≥1mm (n = 25) (Table). A lower level of discordance (31%, n = 35) was observed in therapy selection for patients with stage IIIA melanoma and ≥1 positive lymph node. For first-line therapy in patients with unresectable stage III or IV BRAF wild-type melanoma (n = 16), discordance was 50% between HCPs and KOLs. The level of discordance was higher for first-line therapy for patients with BRAF-mutant melanoma (68%, n = 19). For the management of patients with CNS metastases, 40% of HCP therapy selections were not aligned with KOLs (n = 40). More than one half (56%) of HCPs noted that the tool confirmed their treatment plan, and 21% intend to change practice to align with KOLs. Conclusions: This analysis identified areas of discordance in clinical practice between HCPs and KOLs for advanced melanoma that can guide further education and enhance communication of evolving evidence to HCPs. Our data suggest that use of the decision tool can confirm best practices with KOL recommendations and improve alignment of treatment choices with KOLs. [Table: see text]