Objective:

Drugs that effect basic metabolic pathways including oxidative decarboxylation, such as the isocitrate dehydrogenase inhibitors, evosideneib and ivosidenib may soon be entering the clinic for patients with advanced IDH2 and IDH1 mutant AML. Practitioners may be unfamiliar with the concept of exploitable differences in metabolism between cancer and normal cells. The goal of this study was to determine if an online video lecture with slides could improve knowledge and confidence of hematologists/oncologists regarding therapeutic strategies based on cancer metabolism.

Methods:

Physician members of Medscape Oncology viewed a 30-minute, online video lecture with accompanying slides on therapeutic strategies based on targeting signaling pathways involved in the metabolic reprogramming of cancer cells (http://www.medscape.org/viewarticle/874724).

The effect of online education was assessed using a repeated pairs pre-/post-assessment study design where each participant served as his/her own control. The survey consisted of 3 knowledge questions and 1 self-reported confidence question and data were collected from January 30, 2017 to March 09, 2017. The analysis plan included:

  • For all questions combined, McNemar's chi-square test assessed the response differences from pre- to post-assessment

  • P values measured significance; P values <.05 are considered statistically significant

  • Effect size was calculated using Cramer's V by determining the change in proportion of participants who answered questions correctly from pre- to post-assessment

Results:

Fifty hematologists/oncologists completed all assessment questions during the study period and contributed to the data set. Knowledge improved (P <.05; V=0.221; medium educational effect) following participation in the activity. While 8% answered all 3 questions correctly on pre-assessment, 26% answered all correctly on post-assessment. Specific improvements included (%pre- vs %post-assessment):

  • 170% improvement in understanding that isocitrate dehydrogenase-1 (IDH1) and IDH2 mutations rarely co-occur in the same patient (20% vs 54%, P <.001)

  • 92% improvement in identifying the correct mechanism of action (inhibition of mutant IDH2 enzymes) by the small molecule agent AG-221 (24% vs 46%, P=.021)

  • 17% improvement in recalling the effects of mutations in IDH1 and IDH2 (58% vs 68%, P=.3)

In addition, 52% of hematologist/oncologists indicated that the activity improved confidence in their ability to describe therapeutic strategies to reverse the aberrant metabolic reprogramming seen in many cancer types. Despite these gains, however, approximately 44% of hematologists/oncologists and 37% of pathologists still selected incorrect responses. Targeting aberrant metabolic processes in cancer is a novel approach to oncologic therapy, and most of the participants of this activity indicated that the majority of the content in this program was new to them.

Conclusion:

Participation in an online, 30-minute video lecture with accompanying slides resulted in improved knowledge and confidence of hematologists/oncologists regarding therapeutic strategies and signaling pathways involved in the metabolic reprogramming of cancer cells. Based on the gaps in knowledge after participation in the activity, we also identified a significant need for continued education in this emerging area.

Internal reference:

http://www.medscape.org/viewarticle/874724

Disclosures

Stone: Celgene: Membership on an entity's Board of Directors or advisory committees, Other: DSMB; Roche: Membership on an entity's Board of Directors or advisory committees; Pfizer: Membership on an entity's Board of Directors or advisory committees; Ono: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees; Amgen: Membership on an entity's Board of Directors or advisory committees; Agios: Membership on an entity's Board of Directors or advisory committees, Research Funding; Seattle genetics: Membership on an entity's Board of Directors or advisory committees; Astellas: Membership on an entity's Board of Directors or advisory committees; Arog: Membership on an entity's Board of Directors or advisory committees, Research Funding; Merck: Membership on an entity's Board of Directors or advisory committees; Jazz: Membership on an entity's Board of Directors or advisory committees; Karyopharm: Membership on an entity's Board of Directors or advisory committees; Argenix: Other: DSMB; Otsuka: Membership on an entity's Board of Directors or advisory committees; Cornerstone: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees, Research Funding; Orsenix: Membership on an entity's Board of Directors or advisory committees; Sumitomo: Membership on an entity's Board of Directors or advisory committees; Abbvie: Membership on an entity's Board of Directors or advisory committees; Actinium: Membership on an entity's Board of Directors or advisory committees; Fujifilm: Membership on an entity's Board of Directors or advisory committees.

Topics:
cancer metabolism, oncologists, cancer, tumor cells, malignant, actinium, calculi, enzymes, isocitrate dehydrogenase, isocitrates, ivosidenib

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2017 by The American Society of Hematology
2017
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