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Garnering Knowledge Gains for Treatment of Advanced Renal Cell Carcinoma

An educational enduring live meeting series and online activity provided by i3 Health has demonstrated knowledge gains encompassing the nurse's perspective of evolving treatment paradigms in advanced renal cell carcinoma (RCC).

Kidney cancer is among the top 10 most common cancers in the United States, accounting for approximately 4% of all cancer diagnoses in the US. The American Cancer Society predicted that in 2022, 79,000 new cases of kidney cancer would be diagnosed, with 13,920 of these cases predicted to be fatal. Renal cell carcinoma comprises nearly 90% of all kidney cancer diagnoses and is known to have diverse clinical manifestations, resistance to radiation and chemotherapy, and a lack of early warning signs. The 5-year survival expectancy of patients diagnosed with kidney cancer is 80% but drops to 12% for those with distant disease. Due to its often-asymptomatic presentation, many patients have advanced disease at diagnosis, which is associated with poor outcomes.

To address the knowledge gaps regarding the treatment of individuals with advanced RCC, i3 Health provided a nursing continuing professional development (NCPD)–approved activity, Keeping Pace With Evolving Treatment Paradigms in Advanced Renal Cell Carcinoma: The Nurse's View. The live meeting series was made available between November 11, 2020, and April 15, 2021, and the online enduring activity was made available November 30, 2020, through November 29, 2021. This activity was led by Laura Wood, RN, MSN, OCN®, Renal Cancer Research Coordinator at the Cleveland Clinic Taussig Cancer Center; Nazy Zomorodian, RNC, MSN, CUNP, CCRC, Director of GU Clinical Trials at the University of California Los Angeles Medical Center; Virginia Seery, CRNP, MSN, Nurse Practitioner at the Beth Israel Deaconess Medical Center; and Colleen Lewis, NP, Director of Clinical Operations of the Phase 1 Clinical Trials Program at Emory University Winship Cancer Institute. This activity was supported by independent educational grants from Exelixis, Eisai, and Merck.

The total number of learners who participated in the activity was 227, with 180 completing the activity for credit. Most participants were registered nurses, followed by nurse practitioners, advanced practice nurses, and those who chose "other" as their profession. Attendees had been in their practice for an average of 18.3 years and see an average of five patients with RCC per month.

The baseline data collected revealed knowledge gaps in the following areas: distinguishing the mechanisms of action of immuno-oncology agents and vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors in advanced RCC, differentiating the efficacy and safety profiles of immuno-oncology agents and VEGFR tyrosine kinase inhibitor therapies for advanced RCC, and assessing strategies to improve treatment tolerability, control adverse events, and ensure the provision of patient-centered RCC care. Participants were given an identical pretest and posttest to evaluate knowledge gained throughout the activity.

The pretest assessment revealed knowledge gaps. Only 43% of participants were successful when identifying that VEGFR inhibitors work by increasing T-cell infiltration through normalization of tumor vasculature; 48% were successful when identifying that treatment with sunitinib would not prolong overall survival in a patient with previously untreated programmed cell death ligand 1 (PD-L1)–positive advanced RCC, compared with treatment with nivolumab/ipilimumab; only 37% were successful in understanding that axitinib/pembrolizumab is appropriate for a patient with untreated RCC with sarcomatoid features; 44% were successful when identifying that diarrhea is the adverse event most likely to be experienced for a patient being treated with axitinib/pembrolizumab; and 48% successfully understood that hypertension is an adverse event associated with vascular endothelial growth factor (VEGF)-targeted therapy.

The posttest data revealed that significant learning took place during the activity, with a 35% increase of learners successful in identifying the mechanism of action of VEGFR inhibitors; 34% more successful in identifying the efficacy of sunitinib for PD-L1–positive advanced RCC; 46% more successful in understanding the efficacy of axitinib/pembrolizumab for advanced RCC with sarcomatoid features; 47% more understanding axitinib/pembrolizumab adverse events; and 43% more were successful in identifying VEGF-targeted therapy adverse events.

Upon completion of the activity, 86% of participants felt more confident in treating their patients with RCC, and 84% 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 the educational content and show significant gains in knowledge and proficiency regarding competence in distinguishing the mechanisms of action of novel VEGF-targeted therapies, understanding the efficacy of novel agents for advanced RCC, and understanding the safety profiles of novel agents for advanced RCC. i3 Health has determined that the multidisciplinary team may benefit from CME/NCPD activities that provide RCC education on mechanisms of action of novel therapeutic agents, efficacies of novel therapies, and safety and adverse event management.

For More Information

i3 Health (2022). Keeping pace with evolving treatment paradigms in advanced renal cell carcinoma: the nurse's view: activity outcomes report. Data on file.

American Cancer Society (2022). Key statistics about kidney cancer. Available at: https://www.cancer.org/cancer/kidney-cancer/about/key-statistics.html


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