Educational Gaps Regarding Cyclin-Dependent Kinase 4/6 Inhibitors

A recent survey that will be presented at the San Antonio Breast Cancer Symposium sought to identify knowledge gaps and potential areas for improvement in education involving the use of cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) to treat hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2–) breast cancer.

CDK4/6i could significantly improve outcomes for these patients. “However, given the relative short time period of their availability, appropriate evidence-based uses of CDK4/6i therapies depend on effective education and implementation strategies,” the researchers noted. “In the context of an accredited continuing medical education (CME) and quality improvement (QI) program, we conducted a survey study to identify educational needs and areas for improvement involving CDK4/6i decision-making and clinical management.”

Medical oncologists and clinical staff from two U.S. healthcare systems were invited to complete a baseline survey pertaining to challenges, barriers, and education and training needs in the management of patients with HR+/HER2– breast cancer, particularly regarding the use of CDK4/6i therapies. The researchers further analyzed electronic medical records (EMRs; n=100) in both systems for women with HR+/HER2– breast cancer. The oncology teams took part in CME/QI activities that included national breast cancer research and education leaders sharing the baseline survey results and feedback from the EMR audit. They were then assisted in forming strategies to face the identified challenges.

Overall, 15 medical oncologists, three nurses, and two QI personnel completed the survey. A significant portion of respondents said they were dissatisfied with current CDK4/6i treatment algorithms (40%), scheduling of patient follow-up visits (35%), team-based coordination of care (15%), and protocols for supportive care (15%).

Common challenges in managing patients with HR+/HER2– breast cancer included identifying which patients would benefit from CDK4/6i therapies (35%), monitoring patients for disease progression (25%), and receiving support from administrative leadership (15%). When asked about reducing the likelihood that patients would discontinue CDK4/6i due to toxicity, the respondents suggested increasing interprofessional collaboration and care coordination (45%) and providing education about adverse events to patients and caregivers (20%) and oncology clinical team members (15%).

The action plans created by the oncology teams during the CME/QI activities included the establishment of protocols and EMR tracking mechanisms to monitor patients using CDK4/6i therapies, tracking CDK4/6i dispensing at pharmacies, and recording patient characteristics (i.e., staging, menopausal status, progression to guide individualized treatment decision-making).