i3 Health has provided an educational activity that has challenged knowledge gaps experienced by the health care team regarding updates on immunotherapeutic strategies for recurrent or metastatic cervical cancer. This continuing medical education (CME)/nursing continuing professional development (NCPD)–accredited activity, which was presented as both a Video Viewpoint Strategy Session and a podcast, provided significant gains in proficiency amongst the health care professionals who participated.
The American Cancer Society estimates 13,960 new cases of cervical cancer to be diagnosed in the United States this year, and 4,310 people to die of the disease. The 5-year overall survival rate is 58% for women with regional disease and 17% for those with distant disease; amongst Black women, the prognosis is worse. A significant proportion of patients develop advanced disease, which is rarely curable with available therapies, and treatment is often limited to palliative care. Deaths have declined during the past few decades due to screening and heightened awareness, yet this malignancy continues to be a global health concern and is considered an epidemic in parts of the world. Due to these challenges, it is imperative that the multidisciplinary cancer team participate in educational activities to stay up-to-date on strategies and novel treatment options for cervical cancer.
To address the knowledge gaps experienced by the health care team regarding immunotherapeutic strategies in cervical cancer, i3 Health provided the online educational activity from August 25, 2021, until August 24, 2022. Leading this activity were two key researchers in the field: Bradley J. Monk, MD, FACS, FACOG, a Professor in the Division of Gynecologic Oncology at the University of Arizona College of Medicine, and Jennifer Filipi, MSN, FNP-C, a Nurse Practitioner on the Gynecologic Oncology Team at Massachusetts General Hospital.
Between the Video Viewpoint Strategy Session and the podcast, a total of 1,620 learners participated in the activity, with 348 moving on to complete the activity for credit. Most participants were registered nurses, followed by physicians, nurse practitioners, pharmacists, physician assistants, and those who chose "other" as their profession. Learners had been in practice for an average of 17 years and saw an average of eight patients with cervical cancer per month.
The baseline data collected revealed knowledge gaps in the following areas: evaluating the utility of biomarker testing in the management of advanced cervical cancer, assessing recent clinical trial data on the use of novel immunotherapies in the treatment of recurrent and metastatic disease, and evaluating strategies to manage adverse events associated with novel immunotherapies for cervical cancer.
Participants were given a matching pretest and posttest at the beginning and end of the activity, respectively. The pretest revealed that 65% of participants were able to successfully identify programmed death ligand-1 (PD-L1) as a biomarker to test for when conducting a pathologic assessment of a patient with advanced cervical cancer which was previously treated with carboplatin/paclitaxel/bevacizumab; 43% were successful in identifying pembrolizumab as the appropriate second-line treatment for a patient with metastatic cervical cancer with microsatellite instability-high (MSI-H)/mismatch repair deficiency (dMMR).; only 19% were successful in identifying cemiplimab as the second-line therapy most likely to prolong overall survival for a patient with metastatic cervical cancer that is neurotrophic tyrosine receptor kinase (NTRK) fusion–negative and resistant to platinum-based chemotherapy; and 63% successfully understood that the appropriate strategy for managing grade 2 hepatitis in a patient with recurrent cervical cancer who is enrolled in a clinical trial of atezolizumab is to hold the drug, recheck liver function tests (LFTs) every 3 days, and consider oral steroids.
The posttest assessment revealed significant knowledge gains for each learning outcome: 34% more participants (99% total) successfully understood biomarker testing for advanced cervical cancer; 46% more (89% total) successfully understood second-line therapy for metastatic cervical cancer with MSI-H/dMMR; 55% more (73% total) successfully understood therapy for NTRK fusion–negative platinum-based chemotherapy–resistant recurrent metastatic cervical cancer; and 35% (98% total) successfully understood management of atezolizumab-associated hepatitis.
Upon completion of the activity, 87% of participants reported that they felt more confident in treating their patients with recurrent/metastatic cervical cancer, and 87% reported 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 immunotherapeutic strategies for recurrent and metastatic cervical cancer. Based on these data, i3 Health has determined that the multidisciplinary team may benefit from CME/NCPD activities that provide cervical cancer education on the utility of biomarker testing that can impact individual patients' treatment selection and management; efficacy and safety data on emerging immunotherapies for recurrent and metastatic cervical cancer; and strategies for managing adverse events associated with novel immunotherapies for cervical cancer and optimizing treatment experiences.
i3 Health (2022). Update on immunotherapeutic strategies for recurrent and metastatic cervical cancer: activity outcomes report. Data on file.
American Cancer Society (2023). Key statistics for cervical cancer. Available at: https://www.cancer.org/cancer/cervical-cancer/about/key-statistics.html
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