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Providing Proficiency for Personalized Care Plans for Metastatic Colorectal Cancer

An educational enduring online activity provided by i3 Health has demonstrated knowledge gains pertaining to up-to-date treatment and personalized health care plans for metastatic colorectal cancer (CRC).

Recently the American Cancer Society estimated that CRC would see 151,030 new cases, with 52,580 of these diagnoses being fatal, this year alone, making CRC the third most commonly diagnosed cancer in the United States. If found early, CRC can be and is often cured, with a 5-year survival rate of 90% for a localized stage. However, only 37% of patients are diagnosed at a localized stage, most likely due to the fact that CRC often does not exhibit symptoms and the use of routine screening is suboptimal, causing most patients to be diagnosed at later stages. Approximately 21% of patients present with metastatic disease, which is associated with a 5-year survival rate of only 14%.

To address the knowledge gaps experienced by medical professionals surrounding the topic of treatment strategies and personalized care plans for patients with metastatic CRC, i3 Health provided a continuing medical education (CME)-approved live meeting series (n=7), and online enduring activity, Defining Personalized Care Plans in Metastatic Colorectal Cancer. Those who led these meetings and activity were Tanios Bekaii-Saab, MD, Chairperson, Professor of Medicine at Mayo Clinic Cancer Center; Andrea Cercek, MD, Medical Oncologist at Memorial Sloan Kettering Cancer Center; John Strickler, MD, Medical Oncologist at Duke Cancer Center; and Kristen Ciombor, MD, MSCI, Associate Professor of Medicine at Vanderbilt University Medical Center. This activity was supported by educational funding provided by Amgen.

Between the live meetings and the online activity, a total of 504 learners participated, with 347 of them going on to complete the activity for credit. Most learners were registered nurses (69%) and physicians (14%), followed by fellows (6%), nurse practitioners (2%), pharmacists (2%), physician assistants (1%), advanced practice nurses (1%), clinical nurse specialists (1%), and those who chose "other" as their profession (5%).

The baseline data collected revealed knowledge gaps in the following areas: distinguishing prognostic factors that can help tailor treatment to individual patients with metastatic CRC; evaluating recent study findings on novel therapies for newly diagnosed and relapsed/refractory metastatic CRC; and assessing strategies to optimize treatment experiences and ensure patient-centered metastatic CRC care. To assess knowledge gains throughout the activity, learners were given a matching-pairs pretest and posttest.

The pretest, administered prior to starting the activity, revealed that 76% of participants understood that bevacizumab/chemotherapy should prolong overall survival for a patient with treatment-naive, RAS wild-type, microsatellite-stable (MSS) right-sided metastatic CRC compared with cetuximab/chemotherapy; 31% correctly identified that pembrolizumab is more likely to produce a response in a patient with treatment-naive microsatellite instability (MSI)-high metastatic CRC compared with chemotherapy; only 12% identified intestinal obstruction as the grade ≥3 adverse event most likely to be experienced by a patient with BRAF-mutated metastatic CRC treated with encorafenib/cetuximab; 42% correctly identified that a fixed dose of 160 mg regorafenib would not prolong a patient's overall survival compared with a dose escalation strategy starting at 80 mg; and 76% identified FOLFIRI (leucovorin/fluorouracil/irinotecan)/panitumumab as the appropriate first-line treatment for a patient with previously untreated KRAS/NRAS/BRAF wild-type, human epidermal growth factor receptor 2 (HER2)–negative, MSS left-sided metastatic CRC.

Significant learning took place, as revealed by the posttest data: 23% more participants understood bevacizumab efficacy for right-sided RAS wild-type MSS metastatic CRC; 61% more understood the likely response of pembrolizumab for untreated MSI-high metastatic CRC; 66% more understood adverse event monitoring for encorafenib/cetuximab treatment; 53% more understood regorafenib dose escalation for KRAS-mutated metastatic CRC; and 20% more understood FOLFIRI efficacy for untreated KRAS/NRAS/BRAF wild-type, HER2-negative MSS-left sided metastatic CRC.

Upon completion of the activity, 82% of participants felt more confident in their understanding of and ability to treat patients with CRC, and 83% 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 online educational content and show significant gains in knowledge and proficiency regarding care of metastatic colorectal cancer. i3 Health has determined that the multidisciplinary team may benefit from CME/NCPD activities that provide prognostic factors to tailor treatment selection, efficacy and safety of novel therapies, and strategies to optimize treatment experiences and ensure patient-centered CRC care.

Resources

i3 Health (2022). Defining personalized care plans in metastatic colorectal cancer: activity outcomes report. Data on file.

American Cancer Society (2022). Colorectal cancer statistics. Available at: https://www.cancer.net/cancer-types/colorectal-cancer/statistics


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