Addressing Knowledge Gaps in Metastatic Triple-Negative Breast Cancer Treatment and Care
An educational activity provided by i3 Health has delivered significant improvement in knowledge regarding treatment advances and personalized care for patients with metastatic triple-negative breast cancer (TNBC).
Breast cancer is the most commonly diagnosed cancer and the second-leading cause of cancer-related death among women in the United States. Approximately 15% of cases are classified as triple-negative, lacking expression of estrogen, progesterone, and human epidermal growth factor 2 (HER2) receptors. Because TNBC does not respond to hormone therapies or targeted agents, treatment options are limited, and patients have a poor prognosis compared with other subtypes of breast cancer. Personalized care plans vary based on individual patient characteristics, tumor biomarkers, aggressiveness of the malignancy, response to previous therapies, and cumulative doses, making treatment planning a challenge.
To address the knowledge gaps experienced by health care professionals regarding TNBC treatment, i3 Health provided Metastatic Breast Cancer: Applying Treatment Advances to Personalized Care, a continuing medical education (CME)– and nursing continuing professional development (NCPD)–approved activity. Two live webinars were held on July 13 and 15, 2021, followed by an enduring video made available on i3 Health's website from July 23, 2021, through July 22, 2022. The activity was chaired by Sara Hurvitz, MD, FACP, Professor of Medicine and Director of the Breast Cancer Clinical Trials Program at David Geffen School of Medicine at the University of California, Los Angeles. The activity was supported by an independent educational grant from Merck.
A total of 2,925 individuals attended one of the live webinars or participated in the enduring activity, with 882 learners completing the activity for credit. The majority of participants were registered nurses (88%), followed by nurse practitioners, physicians, advanced practice nurses, pharmacists, physician assistants, clinical nurse specialists, and those who chose "other" as their profession. Attendees saw an average of 11 patients with TNBC per month and had been in practice for an average of 18.9 years.
The baseline data collected revealed knowledge gaps in the following areas: evaluating clinical and molecular factors that can inform personalized care plans for patients with metastatic TNBC; differentiating emerging efficacy and safety data on novel therapies for metastatic TNBC; and assessing strategies to manage treatment-related adverse events and improve quality of life for patients with metastatic TNBC.
Learners were given a matching pretest and posttest at the beginning and end of the activity, respectively. The pretest revealed that only 16% of learners participating in the enduring activity identified that PIK3CA testing should be performed in patients with stage IV hormone receptor (HR)–positive, HER2-negative TNBC; only 53% recognized pembrolizumab plus chemotherapy as the most appropriate therapy for a patient with programmed death ligand 1 (PD-L1)–positive metastatic TNBC; only 53% understood that the management of grade 3 atezolizumab-related dermatitis involves holding therapy and initiating prednisone, oral antihistamines, and topic emollients; and only 27% identified anemia as adverse event most likely to be experienced by a patient receiving olaparib.
The posttest assessment revealed significant knowledge gains for each learning outcome: 78% more learners (94%) identified that PIK3CA testing should be performed in patients with stage IV hormone receptor (HR)–positive, HER2-negative TNBC; 31% more learners (84%) recognized pembrolizumab plus chemotherapy as the most appropriate therapy for a patient with programmed death ligand 1 (PD-L1)–positive metastatic TNBC; 41% more learners (94%) understood that the management of grade 3 atezolizumab-related dermatitis involves holding therapy and initiating prednisone, oral antihistamines, and topic emollients; and 64% more learners (91%) identified anemia as adverse event most likely to be experienced by a patient receiving olaparib.
Upon completion of the activity, 85% of learners who completed the activity reported they felt more confident in treating their patients with TNBC, and 86% 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 treatment advances and personalized care plans for metastatic TNBC. Based on the data provided, i3 Health has determined that the multidisciplinary team may benefit from CME/NCPD activities that provide TNBC education on the following: clinical and molecular factors to inform personalized care plans, emerging efficacy and safety data on novel therapies, and strategies to manage treatment-related adverse events and improve quality of life.
References
i3 Health (2022). Metastatic triple-negative breast cancer: applying treatment advances to personalized care. Activity outcomes summary report. Data on file.
