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Haleh Kadkhoda



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    PD01 - Poster Discussion Session (ID 4)

    • Event: NACLC 2019
    • Type: Poster Discussion Session
    • Track:
    • Presentations: 1
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      PD01.02 - Oncologists’ Management of Advanced NSCLC: A Simulation-Based Performance Assessment (ID 52)

      15:45 - 16:45  |  Author(s): Haleh Kadkhoda

      • Abstract

      Background:
      The treatment of advanced non-small cell lung cancer (NSCLC) has changed dramatically in the immunotherapy era, challenging oncologists to stay current and integrate new data into practice.


      Method:
      An online continuing medical education (CME) virtual patient simulation (VPS) activity developed by Medscape and the Society for Immunotherapy of Cancer was launched December 13, 2018. The VPS consists of two cases of patients with advanced NSCLC accessible through an educational platform that allows oncologists to assess, diagnose, and treat the patients using an extensive diagnostic and therapeutic database that matches the scope and depth of clinical practice. Each clinical decision is analyzed in real time and accompanied by immediate clinical guidance (CG) based on evidence and faculty recommendations. Oncologists can change their initial decision based on CG.


      Results:
      At initial analysis, 55 oncologists completed case 1 (first-line [1L] treatment) and 37, case 2 (second-line [2L]). In case 1, most oncologists ordered PD-L1, EGFR, and ALK testing prior to selecting therapy (65%, 64%, and 62%, respectively), but order rates were lower for BRAF and ROS1 (38% and 20%, respectively). Clinical guidance produced a statistically significant 275% relative increase in the proportion of learners selecting an appropriate, evidence-based 1L regimen and a 380% relative increase for guideline-preferred therapy (P<0.001 for both; Table). For 2L treatment, evidence-based selections increased 86% (P0.001) and preferred-regimen selections increased 79% (P0.001). Case Pre-CG, % Post-CG, % P value Case 1 (N=55) Evidence-based 1L therapy 15% 55% 0.001 Guideline-preferred 1L therapy 9% 44% 0.001 Case 2 (N=37) Evidence-based 2Ltheray 38% 70% 0.001 Guideline-preferred 2L therapy 38% 68% 0.001


      Conclusion:
      Simulation-based CME that immerses and engages learners in an authentic and practical learning experience significantly improved oncologists’ performance selecting appropriate therapy for the treatment of advanced NSCLC, yet gaps remain. Adherence to guideline-recommended molecular testing prior to selecting 1L therapy was suboptimal, and many learners did not choose optimal therapy for the case patients even after clinical guidance. These findings demonstrate an ongoing need for education on how to diagnose, classify, and treat advanced NSCLC.