Conquering Knowledge Gaps Concerning Therapeutic Advances in T-Cell Lymphoma
A learning opportunity provided by i3 Health has demonstrated significant knowledge gains regarding therapeutic advances in T-cell lymphoma (TCL).
T-cell lymphoma is a rare type of non-Hodgkin lymphoma with many different subtypes, including peripheral TCL, anaplastic large cell lymphoma, adult T-cell leukemia/lymphoma, angioimmunoblastic TCL, and cutaneous TCL. TCL makes up less than 15% of total non-Hodgkin lymphomas. Mycosis fungoides (MF), the most common form of cutaneous TCL, frequently mimics symptoms associated with other skin conditions and can be difficult to diagnose in its early stages. Some patients develop Sézary syndrome, a rare, aggressive form of cutaneous T-cell lymphoma that affects both the skin and peripheral blood. Because of the many subtypes and complexities of TCL, determining prognosis is exceedingly difficult, and the treatment of these patients with advanced disease remains a challenge.
To confront the knowledge gaps concerning therapeutic advances in TCL, i3 Health provided both a live webinar series and online enduring continuing medical education (CME)- and nursing continuing professional development (NCPD)–approved activity, Updates on Therapeutic Advances in T-Cell Lymphoma. This activity was led by Steven Horwitz, MD, a Medical Oncologist at Memorial Sloan Kettering Cancer Center and was supported by independent educational grants from Kyowa Kirin and Seagen.
The total number of learners who attended the live series and online activity was 864, with 672 of these learners completing the course for credit. The live webinars were held on March 11, 2021, and March 15, 2021, with the online activity being available after that from March 18, 2021, to March 17, 2022. Most learners who participated were registered nurses (84.3%), followed by physicians (5.6%), nurse practitioners (3.8%), advanced practice nurses (1.7%), pharmacists (0.8%), clinical nurse specialists (0.5%), physician assistants (0.5%), and those who chose "other" as their profession (2.9%). Attendees saw an average of five patients with TCL per month and had been in practice for an average of 16.4 years.
The baseline data collected, revealed by the pretest scores, demonstrated a shortcoming of knowledge in the following areas: utilizing molecular characteristics to differentiate between subtypes of TCL, evaluating emerging efficacy and safety data on novel therapies for peripheral and cutaneous TCL, and applying strategies for managing adverse events associated with novel TCL therapies. Participants were given an identical pretest and posttest to evaluate knowledge gained throughout the activity.
Prior to the start of the live webinars, only 38% of learners successfully identified angioimmunoblastic T-cell lymphoma (AITL) as the peripheral T-cell lymphoma (PTCL) subtype in which TET2 mutations are most common; 69% correctly identified that a patient with CD30-positive PTCL starting treatment with brentuximab vedotin/CHP (cyclophosphamide/doxorubicin/prednisone) should be given granulocyte colony-stimulating factor (G-CSF) as primary prophylaxis; 51% correctly identified that a patient with newly diagnosed PTCL-T follicular helper (PTCL-TFH) being treated with oral azacitidine/CHOP (cyclophosphamide/doxorubicin/vincristine/prednisolone) is likely to achieve a complete response with this regimen; 46% correctly identified that vorinostat would not prolong progression-free survival for a patient with previously treated stage IVB MF compared with mogamulizumab; and 90% of learners correctly identified that a patient with previously treated CD30-positive primary cutaneous anaplastic large cell lymphoma (pcALCL) being treated with brentuximab vedotin would not experience prolonged progression-free survival compared with methotrexate.
Significant learning took place during the live webinar meetings; while only 5% more learners successfully identified TET2 mutation frequency in PTCL subtypes, 12% more learners correctly identified the need for G-CSF prophylaxis against febrile neutropenia with brentuximab vedotin plus CHP; 11% more correctly identified the efficacy of oral azacitidine/CHOP for newly diagnosed PTCL-TFH; 16% more correctly identified the efficacy of mogamulizumab for previously treated stage IVB MF; and 10% more correctly identified the efficacy of brentuximab vedotin compared with methotrexate for previously treated CD30-positive pcALCL.
Prior to the start of the online activity, participants were given the same pre- and posttest as the live learners. The pretest, again, revealed a need for further proficiency, with only 23% of learners successful in identifying TET2 mutation frequency in PTCL subtypes; 71% correctly identifying the need for G-CSF prophylaxis against febrile neutropenia for brentuximab vedotin plus CHP; 67% correctly identifying the efficacy of oral azacitidine/CHOP; 32% correctly identifying the efficacy of mogamulizumab; and 80% correctly identifying the efficacy of brentuximab vedotin compared with methotrexate.
Major knowledge gains took place during the posttest of the online activity; 54% more learners identified TET2 mutation frequency in PTCL subtypes; 27% more identified the need for G-CSF prophylaxis against febrile neutropenia for brentuximab vedotin plus CHP; 29% more identified the efficacy of oral azacitidine/CHOP; 60% more identified the efficacy of mogamulizumab; and 18% more correctly identified the efficacy of brentuximab vedotin compared with methotrexate.
Upon completion of the activity, 81% of learners stated they felt more confident in treating their patients with TCL, and 82% believed that the material presented would be used to improve the outcomes of their patients.
The results revealed by the posttest data confirm the effectiveness of the provided educational content and show the significant increase in learners' knowledge and competence regarding therapeutic advances in TCL. i3 Health has determined that the multidisciplinary team may benefit from CME/NCPD activities that provide education on the utilization of molecular characteristics to differentiate between subtypes, efficacy and safety data on novel therapies, and strategies to monitor and manage adverse events.
For More Information
i3 Health (2022). Update on Therapeutic Advances in T-Cell Lymphoma: activity outcomes summary report. Data on file.