e23321 Background: The incidence of endometrial cancer (EC) has increased in the past decade. Integration of biomarker (BM) testing, chemo-immunotherapy, and multidisciplinary collaboration are essential to improve outcomes but adds complexity for oncologists. This initiative involved oncology teams from community clinics to assess current practices and develop and implement action plans to overcome barriers to optimal evidence-based treatment and patient (pt)-centered care. Methods: In 2024, healthcare providers (HCPs, N = 61) from four US community oncology clinics completed baseline surveys assessing attitudes, practice patterns, and challenges in EC management. HCPs participated in audit-feedback sessions (N = 65) to identify root causes of practice gaps and develop and implement action plans. Clinic champions (1-4 per clinic) completed follow-up surveys (N = 11) and participated in a workshop (N = 10) to assess sustainable practice changes and exchange solutions related to action plan implementation at their sites. Results: Baseline surveys identified variability in BM testing practices across community clinics. While most HCPs routinely assessed HER2 expression (72%), microsatellite instability or mismatch repair (67%), p53 abnormality (67%), and estrogen and progesterone receptors (66%), fewer assessed tumor mutational burden (41%), POLE mutations (20%), or NTRK fusions (15%). Reported use of chemo-immunotherapy, which is often BM-directed, for advanced or recurrent EC varied across HCPs (median: 70%, range 5%-100%). HCPs’ top-reported barriers to integrating BM-directed therapies were (1) keeping up with the latest guideline recommendations and clinical evidence for BM-directed therapies and (2) pt factors. Top barriers to multidisciplinary team-based care included low frequency of communication or communication barriers and misalignment on methods of communication. Thirty-eight percent of HCPs emphasized that enhanced collaboration across interprofessional teams would most improve care for EC pts. Prior to the sessions, only 40% of HCPs felt somewhat or very comfortable (4/5 Likert scale) interpreting and applying BM results to guide treatment for EC pts; following the sessions, this increased to 57%. Most clinic champions (55%) reported implementing BM testing workflow improvements after the sessions, including the adoption of shared communication platforms with pathologists to streamline requests and shorten turnaround times. Conclusions: This multi-center initiative revealed challenges in BM integration and team-based coordination in the care of EC pts in community oncology clinics. Audit-feedback sessions, action planning, and structured collaboration can support improvements in testing workflows and communication, and ultimately, may help community clinics accelerate adoption of evidence-based treatment for EC pts.
Eskander et al. (Thu,) studied this question.