Testing, treatment, and teamwork: Differential learning curves and translational barriers in EGFR-mutated NSCLC care.

Abstract

e23216 Background: Advances in EGFR-targeted therapies have transformed the management of non–small cell lung cancer (NSCLC), expanding options while increasing clinical complexity. Translating rapidly evolving evidence into real-world practice requires timely biomarker testing, appropriate treatment selection, and effective multidisciplinary coordination. As care for EGFR-mutated NSCLC becomes more complex, understanding how clinicians acquire and apply these competencies may help identify translational barriers, particularly in community practice. Methods: We evaluated outcomes from nine accredited continuing medical education/professional development (CME/PD) activities focused on EGFR-mutated NSCLC conducted between January 2023 and February 2025. More than 5,500 learners participated, including medical and radiation oncologists, pulmonologists, thoracic surgeons, pathologists, and nurse practitioners/physician assistants. Learning objectives were grouped into three domains central to evidence translation: biomarker testing, treatment selection and management, and multidisciplinary teamwork. Pre- and post-activity assessments measured changes in knowledge and applied clinical decision-making. Outcomes were stratified by specialty, practice setting (academic vs community), and EGFR TKI prescribing experience. Results: Performance improved across all domains; however, the magnitude and trajectory of gains varied. Biomarker testing showed the lowest baseline performance among non-oncology specialties (≈25%–50%) but the largest absolute improvements post-education, particularly among pulmonologists and pathologists, with post-test performance increasing to approximately 85%–90%. Treatment selection and management also demonstrated substantial gains, with community-based clinicians achieving post-test performance comparable to academic peers. In contrast, improvements in multidisciplinary teamwork were more modest and variable. Although surgeons and pathologists demonstrated marked gains (absolute increases of ~30–50 percentage points), teamwork remained the lowest-performing domain post-education for several roles, particularly among prescribers with lower EGFR TKI experience. Conclusions: Educational initiatives addressing EGFR-mutated NSCLC reveal differential learning curves across competencies required to translate scientific advances into practice. While biomarker testing and treatment selection are highly responsive to education, multidisciplinary teamwork appears constrained by system-level and workflow factors beyond knowledge alone. Improving real-world adoption of EGFR-targeted therapies will likely require educational strategies complemented by structural approaches that support coordinated, team-based care, particularly in community oncology settings.