Real-world impact of oncology education on clinical practices at five community cancer care centers.

Abstract

e23003 Background: Broad based molecular testing is an underutilized but essential factor in determining patient candidacy for frontline immunotherapy (IO) for advanced NSCLC. Findings from previous educational initiatives and real-world studies such as Nadler et al. and Velcheti, et al. indicate that understanding the importance of molecular testing to optimize therapy in NSCLC, remains an educational gap among oncology clinicians. Based on this real-world data, an educational initiative was developed to impart demonstrable change in clinician’s molecular testing practices and IO treatment selection. Methods: Grand round modules held at 5 community cancer centers facilitated learners’ ability to incorporate molecular testing and treatment strategies into clinical practice, which may improve patient outcomes. Physician leaders were leveraged at each center in order to increase learner engagement, encourage peer-to-peer learning and foster a learning community and potentially encourage institutional changes. Educational impact was assessed via a matched Pre/Post Test methodology which incorporated fact based and procedural information as well as asking learners to rate their confidence and intent to perform. To evaluate educational impact, pre and post educational intervention, 100 tumor board patient cases collected by OncoLens from the five centers were analyzed to assess any change in molecular testing practices, and therapeutic selection. Results: 174 learners participated in the grand round modules, results from matched Pre- and Post-Test showed significant improvements in overall proficiency, +51% in module 1 and +89% in module 2, alongside self-reported increased intent to utilize broad-based molecular testing +93% and IO +236% in advanced NSCLC. Post-intervention tumor board cases demonstrated that effective education can lead to real-world practice changes; there was an increase (+207%) in molecular testing of NSCLC, 75% increased use of liquid biopsy, the shift towards more comprehensive testing was accompanied by more judicious determination of IO candidacy, and a 52% increase in IO implementation. Additionally, feedback from the physician leaders reported that institutional changes were implemented following the educational initiative; 3 centers now actively consider liquid biopsy if tissue quantity is not sufficient (QNS), one institution has implemented reflex testing to improve time to treatment. Conclusions: Findings suggest that onsite CME/CE targeting understanding and proficiency in molecular testing for advanced NSCLC, can translate into real-world change to clinical practice that optimizes therapeutic decision-making in patient care; community cancer center case data supports the efficacy of the education on real-world clinical practices. Nadler E, et al.doi: 10.1016/j.ctarc.2022.100522. Velcheti V, et al.doi: 10.1371/journal.pone.0206370.