Background The immunotherapy revolution in non-small cell lung cancer (NSCLC) has swiftly expanded from advanced disease to early-state, curative-intent settings, transforming standards of care and offering hope for improved outcomes for patients with resectable stages I-III NSCLC. Optimal individualized selection of perioperative neoadjuvant and/or adjuvant immunotherapy requires multidisciplinary collaboration, however, specifically through participation in discussions, tumor boards, and consultations among members of the care team. Despite evidence showing that multidisciplinary cancer treatment improves survival over traditional care, cancer care is often siloed and segregated, with little emphasis on collaboration.
Methods PVI developed a CME series comprising five live symposia and two on-demand online activities designed to increase the skills of thoracic surgeons, medical oncologists, and other multidisciplinary specialists regarding the use of neoadjuvant and adjuvant immunotherapies in stage I-III resectable NSCLC and facilitate their clinical integration through effective team-based communication and collaboration. In addition to evidence reviews and case-based discussions, experts provide guidance on implementation of workflows to improve multidisciplinary care best practices.
To date, more than 1,734 thoracic surgeons, 1,890 medical oncologists, and 230 pulmonologists and pathologists have participated in the initiative. Multiple-choice questions before and after the educational content measured the effect the activities had on skills and intent to change clinical practice.
Results Analysis of participant responses revealed important gains in skills and intent to change practice in all the reviewed activities. In one on-demand activity, participants’ skills in implementing best practices for multidisciplinary communication and collaboration improved by 30%. Following participation in a live symposium at AATS 2023, 99% of responding surgeons indicated an intent to refer patients to medical oncologists for systemic therapy consultation (a 28% absolute gain) while 92% said they would plan to engage in tumor boards or other collaborative interactions with other multidisciplinary specialists to coordinate care for patients with resectable NSCLC. Likewise, after attending another live symposium at STS 2022, 85% of respondents indicated an intent to engage in discussions with the multidisciplinary team to ensure that pathology reports would include essential relevant measures.
Conclusions These CME activities were successful in improving participants’ ability to engage in multidisciplinary collaboration for effective integration of immunotherapies into treatment plans in stage I-III NSCLC. Narrowing these gaps is especially important now when perioperative immunotherapy has shown proven benefits and become the new standard of care, and multidisciplinary discussions are critical to determining which patients are candidates for neoadjuvant or adjuvant immunotherapy, or both.
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