e23328 Background: Community oncology settings face challenges adopting evidence-based protocols for integrating novel therapies such as antibody-drug conjugates (ADCs) into workflows. These challenges are exacerbated by limited experience with new agents, variability in adverse event (AE) management, and lack of standardized workflows, ultimately affecting treatment sequencing, supportive care, and shared decision-making. Methods: In 2025, 51 healthcare professionals (HCPs) from 6 US oncology clinics within a large community network completed surveys assessing practice patterns/barriers related to integration of novel therapies, AE management, supportive care, and patient (pt) education. Site-specific audit-feedback sessions were conducted to identify root causes of gaps and develop action plans, including implementing a TNBC treatment pocket guide. An ensuing network-wide summit was held to share key insights and lessons learned, and develop strategies to address gaps. Results: At baseline, few HCPs reported high confidence integrating ADCs (31%) or determining optimal treatment sequencing (25%). Top barriers included limited experience with agents (35%), uncertainty about sequencing (22%), and concerns about AE management (19%). The toxicities HCPs found most difficult to manage were diarrhea (39%), interstitial lung disease (37%), nausea/vomiting (31%), and neutropenia (29%). Despite known neutropenia risk with sacituzumab govitecan, G-CSF use varied with 27% using primary prophylaxis in high-risk pts, 20% as primary prophylaxis in all pts, 29% as secondary prophylaxis, and 12% reporting no use. About half (51%) of HCPs consistently used supportive care protocols for ADC AE management. While most provided pt education on AE management (82%) and treatment expectations (71%), fewer addressed biomarkers (49%), caregiver education (39%), behavioral health (24%), or clinical trials (20%). Barriers to shared decision-making included difficulty tailoring communication to pt understanding (39%) and limited staff resources (37%). HCPs identified improved supportive care focus (43%) and multidisciplinary communication (45%) as key opportunities to improve care. These findings informed site-specific action plans and network-wide alignment on implementing clinical workflows to improve guideline-aligned care and ADC AE management, integrating the TNBC treatment guide, establishing order sets for supportive care, and developing new patient education resources. Conclusions: Significant gaps in confidence, AE management, and care standardization limit effective ADC integration in community settings. A network-based QI approach and dedicated resources enhanced alignment on practical strategies to improve guideline-concordant, multidisciplinary, and pt-centered care. Ongoing evaluation will assess the impact of these interventions over time.
Mahtani et al. (Thu,) studied this question.