Perception and awareness of cancer immunotherapy among healthcare professionals and students at a tertiary referral center in the MENA region.

Abstract

e23222 Background: Cancer immunotherapy has shaped the management of several malignancies; however, its safe and effective use requires adequate awareness among healthcare professionals. Data on perception and knowledge of cancer immunotherapy in low- and middle-income countries remain limited, highlighting the need for a systematic assessment of educational gaps. Methods: A cross-sectional survey of 335 healthcare professionals and students at the American University of Beirut Medical Center assessed perception and knowledge of cancer immunotherapy using a structured 21-item questionnaire. Participants included physicians, nurses, and medical and nursing students. Descriptive statistics were used to summarize participant characteristics and survey responses. Composite perception and knowledge scores were analyzed using Pearson correlations and multivariate linear regression to identify predictors of higher awareness. Results: Among 335 participants, 38.2% were students and 61.8% were healthcare professionals. Only 11% reported prior formal education in cancer immunotherapy, while 70.7% identified high cost as the main barrier to its use. Only 21.8% correctly identified skin as the most common affected organ, and only 31.6% correctly identified pneumonitis as a potentially life-threatening immune-related adverse event. Only 23.6% correctly identified the recommended initial corticosteroid dose for the management of immune-related adverse events, only 8.4% were aware of the Common Terminology Criteria for Adverse Events. Despite limited training, 78.5% considered immunotherapy awareness relevant to their field, and 65.7% expressed willingness to attend future educational activities. The mean (±SD) perception score was 3.80 (1.69) (range 0-6), and the mean knowledge score was 3.08 (3.41) (range 0-20). Perception and knowledge scores were moderately correlated (r = 0.43, p < 0.001). In multivariable linear regression, higher knowledge scores were independently associated with age > 40 years (β = 0.132, p = 0.042) and more than 5 years of clinical experience (β = 0.17, p = 0.006), while female sex (β = -0.121, p = 0.026) and no regular exposure to cancer patients (β = -0.114, p = 0.042) were associated with lower knowledge scores. Lower perception scores were independently associated with age 31-40 years (β = -0.128, p = 0.049) and no regular exposure to cancer patients (β = -0.153, p = 0.007). Conclusions: Awareness and knowledge of cancer immunotherapy were suboptimal among healthcare professionals and students at a tertiary referral center in Lebanon. Given the expanding use of immunotherapy and limited access to structured training across the MENA region, these findings highlight an urgent need for region-specific educational initiatives to improve safe delivery of immunotherapy in low- and middle-income settings.