Fostering Collaborative Care in Multiple Myeloma: An Update on the Impact of Holistic Education on Decision-Making with Antibody and CAR-T Platforms
Authors: Deluca Carmine , Orlowski Robert Z. , Ahlstrom Jennifer M. , Faiman Beth M. , Ghobrial Irene , Beyer Michael , Wanes Marina , Brugger Abigail 
Published: December 2024

Background: The management of multiple myeloma (MM) continues to be transformed by evidence supporting the use of CD38 antibodies and B-cell maturation antigen (BCMA)-targeted immunotherapies (chimeric antigen receptor (CAR-T) and bispecific antibodies) in newly diagnosed and relapsed/refractory MM (NDMM and RRMM), respectively. However, real-world evidence and survey data show that these approaches are under-utilized across lines of therapy and that educational outreach to patients on their use is inadequate (Puig N et al. ASH 2022. Abstract 1859; Pink S et al. ISPOR 2022. Abstract HSD44; Terpos E et al. Blood Cancer J. 2021;11:40; Adu Y et al. ASH 2023. Abstract 2418).
Methods: To address these gaps, PeerView partnered with HealthTree Foundation for Multiple Myeloma and developed 4 live events and 5 online enduring activities from 06/2022 to 06/2023, to educate clinicians on the evidence and principles for integrating CD38 antibody and BCMA immunotherapy platforms into patient care; initial results suggested that education led to gains in learner knowledge and skills (DeLuca C, et al. ASCO 2024. Abstract e21008) . For this updated analysis, outcomes from an additional live event (June, 2024) were included. The core objectives focused on improving knowledge and skills for integrating CD38 antibodies and BCMA immunotherapy into sequential MM treatment. Through the partnership with HealthTree Foundation, the initiatives featured patient perspectives as well as resources to foster clinician-patient communication. Pre- and post-activity multiple choice questions measured changes in knowledge and skills. Responses from enduring activity learners were compared with those from a matched sample of nonparticipants. In a meta-analysis of outcomes from the 9 activities, learning objectives were grouped by key themes, with changes in knowledge and skills averaged across them.
Results: Total learners: 13,260 (including hematologist-oncologists/oncologists: 8,179; oncology nurses: 1,296). In all activities, learners' knowledge and skills improved, with increases of: 35 percentage points (ppt) in knowledge of new evidence and changing practice guidelines supporting BCMA antibody platforms in RRMM (45% to 80%); 36 ppt in skills in treatment planning and evidence-based integration of CD38 and BCMA-targeting antibodies in the management of MM (52% to 88%); 54 ppt in ability to address safety considerations related to the use of antibody therapy and BCMA immunotherapy (32% to 86%); and 58 ppt in patient interaction skills (eg, counseling, shared decision-making) when using antibody-based and CAR-T platforms (28% to 86%).
Conclusions: Improvements in knowledge and skills, combined with a greater focus on patient-centricity, suggest that learners are poised to more effectively integrate CD38 antibodies and BCMA immunotherapy into guideline-recommended MM care that improves the overall well-being and outcomes of patients with MM.