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Enhancing Knowledge of Small Cell Lung Cancer Treatment and Management

An educational activity offered by i3 Health has provided significant knowledge gains regarding strategies to enhance the clinical outcomes of patients with extensive-stage small cell lung cancer (SCLC)

Among the 238,340 new cases of lung cancer reported in the United States each year, approximately 14% of cases are classified as small cell, a more aggressive subtype compared with its non–small cell counterpart. Most patients present with advanced or metastatic disease, making systemic therapy the cornerstone of management; however, low response rates and limited therapeutic options contribute to a poor survival rate for patients with SCLC. Clinicians face the added challenge of balancing therapeutic selection with patient and tumor characteristics, molecular biomarkers, comorbidities, and treatment tolerability.

To address the knowledge gaps experienced by health care professionals regarding SCLC treatment and management, i3 Health provided Enhancing the Clinical Outcomes of Patients With Extensive-Stage Small Cell Lung Cancer, a continuing medical education (CME)– and nursing continuing professional development (NCPD)–approved activity. A live webinar was held on June 22, 2021, followed by an enduring video made available on i3 Health's website from June 30, 2021, through June 29, 2022. The activity was chaired by Anne Chiang, MD, PhD, Associate Professor at Yale University School of Medicine and Deputy Chief Medical Officer of Smilow Cancer Network. The activity was supported by educational funding provided by Merck.

A total of 935 individuals attended the live webinar or participated in the enduring activity content, with 591 learners completing the activity for credit. Most participants were registered nurses (87%), followed by physicians, nurse practitioners, advanced practice nurses, clinical nurse specialists, physician assistants, and those who chose "other" as their profession. Attendees saw an average of 14 patients with SCLC per month and had been in practice for an average of 11.2 years.

The baseline data collected revealed knowledge gaps in the following areas: connecting emerging therapeutic targets to the pathophysiology of extensive-stage SCLC, evaluating the evidence supporting novel therapeutic strategies for newly diagnosed and relapsed/refractory extensive-stage SCLC, and assessing strategies for managing adverse events associated with novel SCLC therapies and optimizing treatment experiences.

Learners were given a matching pretest and posttest at the beginning and end of the activity, respectively. The pretest revealed that only 37% of learners participating in the enduring activity recognized that grade 2 colitis associated with atezolizumab/etoposide/carboplatin should be managed by starting prednisone and holding atezolizumab; only 15% identified lurbinectedin as the most appropriate treatment option for a patient with previously treated SCLC who relapses less than six months after treatment; only 49% understood that grade 3 pulmonary toxicity associated with durvalumab/carboplatin/etoposide should be managed by administering methylprednisone, consulting pulmonary, and discontinuing durvalumab indefinitely; only 38% recognized that patients who experience immune-related adverse events are more likely to have prolonged survival; and only 26% recalled that prognostic marker testing is still being evaluated in SCLC and does not influence first-line therapy selection.

The posttest assessment revealed significant knowledge gains for each learning outcome: 59% more learners (96%) recognized that grade 2 colitis associated with atezolizumab/etoposide/carboplatin should be managed by starting prednisone and holding atezolizumab; 76% more learners (91%) identified lurbinectedin as the most appropriate treatment option for a patient with previously treated SCLC who relapses less than six months after treatment; 55% more learners (95%) understood that grade 3 pulmonary toxicity associated with durvalumab/carboplatin/etoposide should be managed by administering methylprednisone, consulting pulmonary, and discontinuing durvalumab indefinitely; 53% more learners (91%) recognized that patients who experience immune-related adverse events are more likely to have prolonged survival; and 63% more learners (89%) recalled that prognostic marker testing is still being evaluated in SCLC and does not influence first-line therapy selection.

Upon completing the activity, 85% of learners reported they felt more confident in treating their patients with SCLC, and 85% 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 extensive-stage SCLC. Based on the data provided, i3 Health has determined that the multidisciplinary team may benefit from CME/NCPD activities that provide education on the following topics: connecting emerging therapeutic targets to the pathology of extensive-stage SCLC, evaluating the evidence supporting novel therapeutic strategies for newly diagnosed and relapsed/refractory extensive-stage SCLC, and assessing strategies for managing adverse events associated with novel SCLC therapies and optimizing treatment experiences.

References

i3 Health (2022). Enhancing the clinical outcomes of patients with extensive-stage SCLC: activity outcomes summary report. Data on file.

American Cancer Society (2023). Cancer facts & figures 2023. Available at: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2023/2023-cancer-facts-and-figures.pdf


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