Alona Zer1, Jean Claude Cutz2, Harman Sekhon3, David M Hwang4, Christina Sit1, Manjula Maganti5, Mike Sung1, Matthew Binnie6, Anthony Brade7, Tae Bong Chung8, Suzanne Kamel-Reid4, Narinder Paul5, Ming S Tsao4, Tom Waddell9, Gilda da Cunha Santos4, Milan Patel10, Ron F Carter2, Natasha B Leighl11. 1. Division of Medical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. 2. Department of Pathology, McMaster University, Hamilton, Ontario, Canada. 3. Department of Pathology, The Ottawa Hospital, Ottawa, Ontario, Canada. 4. Department of Pathology, University Health Network, Toronto, Ontario, Canada. 5. Department of Medical Imaging, London Health Sciences Centre, London, Ontario, Canada. 6. Division of Respirology, University Health Network, Toronto, Ontario, Canada. 7. Department of Radiation Oncology, Peel Regional Cancer Centre, Mississauga, Ontario, Canada. 8. Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada. 9. Division of Thoracic Surgery, University Health Network, Toronto, Ontario, Canada. 10. Division of Respirology, Trillium Health Partners, Mississauga, Ontario, Canada. 11. Division of Medical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. Electronic address: Natasha.Leighl@uhn.ca.
Abstract
BACKGROUND: Molecular testing in advanced lung cancer is standard in guiding treatment selection. However, population-wide implementation of testing remains a challenge. We developed a knowledge translation intervention to improve understanding among diagnostic specialists about molecular testing and appropriate diagnostic sampling in lung cancer. METHODS: Specialty-specific education programs were developed from existing literature and input from Canadian leaders in lung pathology, respirology, interventional radiology, thoracic surgery, radiation oncology, and medical oncology. The programs, including key messages, review of current data, existing guidelines, group discussion, and participant feedback, were administered at provincial and national specialty meetings. Participant knowledge was assessed before and after the intervention by using anonymous questionnaires. Molecular (EGFR) testing rates in Ontario were also evaluated before and after the intervention period. RESULTS: Ten programs were administered to diagnostic specialists, including respirologists, pathologists, thoracic surgeons, radiologists, radiation oncologists, and medical oncologists, with completion of 255 preintervention and 219 postintervention surveys. At baseline, 30% were unsure of tissue handling methods for molecular testing, 20% chose an incorrect technique, and half were unfamiliar with how to initiate testing. After intervention, specialist knowledge improved regarding tissue handling and appropriate fixation techniques and uncertainty decreased from 30% to 2% (p < 0.001). A 12% increase (relative increase 57%) in molecular (EGFR) testing requests in Ontario was observed over the intervention period (p = 0.0032). CONCLUSIONS: Significant knowledge gaps exist among diagnostic specialists regarding molecular testing and targeted therapy in lung cancer. This initiative significantly improved understanding of the importance and methods of successful molecular testing and correlated with increased testing rates.
BACKGROUND: Molecular testing in advanced lung cancer is standard in guiding treatment selection. However, population-wide implementation of testing remains a challenge. We developed a knowledge translation intervention to improve understanding among diagnostic specialists about molecular testing and appropriate diagnostic sampling in lung cancer. METHODS: Specialty-specific education programs were developed from existing literature and input from Canadian leaders in lung pathology, respirology, interventional radiology, thoracic surgery, radiation oncology, and medical oncology. The programs, including key messages, review of current data, existing guidelines, group discussion, and participant feedback, were administered at provincial and national specialty meetings. Participant knowledge was assessed before and after the intervention by using anonymous questionnaires. Molecular (EGFR) testing rates in Ontario were also evaluated before and after the intervention period. RESULTS: Ten programs were administered to diagnostic specialists, including respirologists, pathologists, thoracic surgeons, radiologists, radiation oncologists, and medical oncologists, with completion of 255 preintervention and 219 postintervention surveys. At baseline, 30% were unsure of tissue handling methods for molecular testing, 20% chose an incorrect technique, and half were unfamiliar with how to initiate testing. After intervention, specialist knowledge improved regarding tissue handling and appropriate fixation techniques and uncertainty decreased from 30% to 2% (p < 0.001). A 12% increase (relative increase 57%) in molecular (EGFR) testing requests in Ontario was observed over the intervention period (p = 0.0032). CONCLUSIONS: Significant knowledge gaps exist among diagnostic specialists regarding molecular testing and targeted therapy in lung cancer. This initiative significantly improved understanding of the importance and methods of successful molecular testing and correlated with increased testing rates.
Authors: Shelley Kuang; Andrea S Fung; Kirstin A Perdrizet; Kaitlin Chen; Janice J N Li; Lisa W Le; Michael Cabanero; Ola Abu Al Karsaneh; Ming S Tsao; Josh Morganstein; Laura Ranich; Adam C Smith; Cuihong Wei; Carol Cheung; Frances A Shepherd; Geoffrey Liu; Penelope Bradbury; Prodipto Pal; Joerg Schwock; Adrian G Sacher; Jennifer H Law; Tracy L Stockley; Natasha B Leighl Journal: Curr Oncol Date: 2022-06-22 Impact factor: 3.109