Multidisciplinary AE management education for EGFR-mutated NSCLC: Mixed-methods QI outcomes.

Abstract

e23368 Background: Anti-EGFR therapies for EGFR-mutated NSCLC have dermatologic and other adverse events (AEs) that benefit from standardized, multidisciplinary management in community practice. Methods: Three-phase mixed-methods quality-improvement initiative. Phase 1 used Premier Network encounter analytics from ~4,400 hospitals/health systems (Jan 2021–Apr 2024) and interviews with 5 community oncologists (Sep 2024) to define gaps. Phase 2 delivered an ACCME-accredited, on-demand 4-module video CME activity (1.25 credits) plus NPI-targeted microlearning (launched Feb 11, 2025) focused on AE monitoring, referral triggers, and patient counseling. Outcomes included participation, pre/post 3-item knowledge test, confidence ratings, and 3 case-based questions. Phase 3 included follow-up interviews (Nov 2025) and a separate ecological comparison of Premier encounters between baseline (Jan 2021–Apr 2024) and a later period (Jul 2024–Jun 2025). Results: 1,983 clinicians participated (385 enduring CME; 1,598 microlearning); 86% completed the enduring CME. Most challenging AEs were rash/pruritus (49%), ILD/pneumonitis (43%), and infusion-related reactions (37%). Mean test performance improved 31%→57%, and confidence managing dermatologic AEs improved 26%→44%. Case-based performance improved for selecting first-line therapy for EGFR exon 20 insertion NSCLC (+35%; p < 0.01), timing dermatology referral for rash during amivantamab treatment (+30%; p < 0.01), and counseling for nail changes/paronychia (+14%; p < 0.01). In Premier period comparisons, amivantamab encounters increased and patients were more racially/ethnically diverse. AE-related 90-day follow-up visits (overall and dermatologic) were less frequent for amivantamab in the later period (some comparisons p < 0.05; others NS). Dermatologic AE encounters for osimertinib were rare ( < 10 in each period). Post-activity interviews described more consistent documentation, earlier symptom reporting, and clearer referral workflows. Conclusions: ACCME-accredited multidisciplinary education improved clinician knowledge and scenario-based decision-making for AE management in EGFR-mutated NSCLC. Concurrently, Premier Network trends (including fewer AE-related 90-day follow-up visits for amivantamab in a later period) support testable hypotheses that standardized counseling, monitoring, and referral triggers may reduce downstream AE-related utilization; future work should evaluate these hypotheses using exposure-linked designs and post-launch analytic windows.