Improved Understanding of Precision Medicine in BRAF V600E–Mutant Metastatic Colorectal Cancer

Recently, i3 Health provided an educational activity that has challenged knowledge gaps experienced by clinicians regarding precision medicine in BRAF V600E­–mutant metastatic colorectal cancer (CRC).  

Colorectal cancer is the second leading cause of cancer death among men and women in the United States, with the American Cancer Society estimating that there will be 106,970 new cases of colon cancer, 46,050 new cases of rectal cancer, and 52,550 deaths due to colorectal cancer in 2023 alone. The lifetime risk of developing colorectal cancer in men is 1:23 and for women is 1:26. Due to colorectal cancer initially exhibiting no symptoms and the suboptimal use of routine screening, most patients are diagnosed at later stages. In addition, approximately 10% of colorectal cancers harbor a BRAF V600E mutation, which is associated with reduced progression-free survival and overall survival, regardless of disease stage. Despite recent advances in molecular testing and targeted therapies, the optimal treatment approach for BRAF V600E–mutant metastatic colorectal cancer remains unclear, resulting in a poor prognosis. Due to this, it is vital that the multidisciplinary cancer team maintain an updated understanding and knowledge of how to treat BRAF V600E–mutant metastatic CRC.

To address the knowledge gaps concerning precision medicine in BRAF V600E–mutant metastatic CRC, i3 Health provided a continuing medical education (CME)/nursing continuing professional development (NCPD)–approved video viewpoint strategy session and podcast. The activity was made available on the i3 Health website starting November 3, 2021, until November 2, 2022. Leading the activity were two key speakers in the field of CRC: Aparna Parikh, MD, Assistant Professor of Medicine at Harvard Medical School; and Theresa W. Gillespie, PhD, MA, BSN, FAAN, Professor in the Department of Surgery at Emory University School of Medicine of the Winship Cancer Institute.

A total of 1,193 learners participated in the activity with 567 completing the activity for credit. Most learners were registered nurses, followed by nurse practitioners, advanced practice nurses, physicians, physician assistants, and clinical nurse specialists. Of those who completed the activity, the average number of patients with BRAF V600E–mutant metastatic CRC seen per month was six, and the average number of years in practice was 16.

The baseline data collected revealed knowledge gaps in the following areas: applying practice guidelines on BRAF biomarker and genomic testing for patients with metastatic CRC, appraising emerging data on novel treatment combinations and sequences for BRAF V600E–mutant metastatic CRC, and assessing strategies to control adverse events and improve quality of life in patients receiving novel regimens for BRAF V600E–mutant metastatic CRC.

Participants were given a matching pretest and posttest at the beginning and end of the activity, respectively. The posttest assessment revealed statistically significant knowledge gains respective to each question and learning objective. The activity produced a 52% increase in understanding of the selection of pembrolizumab for second-line therapy of deficient mismatch repair (dMMR) or microsatellite instability–high (MSI-H) tumors (pretest 44% versus posttest 96%); a 67% increase in understanding of the prevention of adverse events with dabrafenib/trametinib (pretest 31% versus 98% posttest); a 50% increase in understanding regarding treatment of adverse events associated with encorafenib/cetuximab/binimetinib therapy (pretest 44% versus posttest 94%); a 62% increase in understanding of treatment selection for patients with BRAF V600E–mutated metastatic CRC after prior therapy (pretest 19% versus posttest 81%); and an 86% increase in understanding regarding the guideline-recommended timing of BRAF biomarker testing for patients with CRC (pretest 8% versus posttest 94%).

Upon completion of the activity, 89% of learners reported that they felt more confident in treating their patients with BRAF V600E–mutant metastatic CRC, and 90% reported that they felt that the material presented would be used to improve the outcomes of their patients.

The data revealed by the posttest assessment affirm the effectiveness of online educational content pertaining to the topic of precision medicine in BRAF V600E-mutant metastatic CRC. Based on these data, i3 Health has determined that the multidisciplinary team may benefit from CME/NCPD activities that provide metastatic CRC education on therapeutic implications of BRAF biomarker and genomic testing for patients with metastatic CRC; efficacy of novel treatment combinations and sequences for metastatic CRC; and management of adverse events associated with novel regimens for metastatic CRC.

Resources

I3 Health (2022). Applying precision medicine in BRAF V600E–mutant metastatic colorectal cancer: activity outcomes report. Data on file.

American Cancer Society (2023). Key statistics for colorectal cancer. Available at: https://www.cancer.org/cancer/types/colon-rectal-cancer/about/key-statistics.html


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