Report Details Renal Cell Cancer Treatment Gaps

A recent comprehensive report identified seven practice performance gaps in the treatment and management of patients with kidney cancer in the United States.

“Renal Cell Carcinoma: Understanding Professional Practice Gaps and Educational Needs among Oncologists in the United States” presents an integrated analysis of data collected through a mixed-methods needs assessment. It relied on qualitative interviews and quantitative surveys to pinpoint areas where the availability of better clinical tools and education may result in better treatment for patients with kidney cancer.

“To improve the standard of care, we need to understand factors that affect the clinical reasoning of medical oncologists in their approaches to patients with kidney cancer,” says Brian Rini, MD, of Cleveland Clinic’s Department of Solid Tumor Oncology. Dr. Rini, who spearheaded the report, says the fact that kidney cancer is relatively rare contributes to a number of treatment lapses and challenges that doctors face. The report found:

1. Lack of knowledge on key predictors of poor risk/short survival
2. Problems selecting an optimal treatment option for patients with poor risk RCC
3. Problems with clinical decision-making regarding the decision to either continue/escalate the dose of a current agent or switch to another agent based on patient response
4. Challenges stemming from the rapid integration of newly FDA-approved agents into clinical practice
5. A lack in proper recognition of non-radiologic progression and its importance in treatment decisions
6. Challenges in multidisciplinary collaboration, specifically with surgeons and primary care physicians
7. Lack of knowledge of QoL assessment tools and difficulty in considering this key factor in the formulation of a treatment plan, which makes it difficult to optimize the risk-benefit balance of care options

Dr. Rini says these findings will contribute to the body of knowledge in the field and provide evidence to support the design of clinical tools, educational programs and interventions to improve treatment. “The only way to effectively deal with such problems is to bring them into the light. We can’t fix issues if we don’t know what they are,” he says.

CMEs are an effective and broad-based way to bring the latest clinical information to a wide swath of clinicians who treat patients with renal cell carcinoma. Most importantly, they promote the dissemination of evidence-based data. “We have to make physicians and care teams aware of evidence-based medicine and encourage them to apply it in their practices,” says Dr. Rini.

Medical oncologists need to make it a priority to keep up to date with the latest treatment options for cancer types they encounter in their practices. Specific recommendations from this report provide evidence-based data to better target and adapt nationwide educational programs.

The report was produced in collaboration by the Annenberg Center for Health Sciences at Eisenhower Medical Center, Rancho Mirage, Calif.; Clinical Care Options, LLC, a global leader in the development of CME courses and online publishing; and AXDEV, Brossard, Quebec, Canada, a performance optimization company. It was funded by a grant from Pfizer, Inc., and presented to the company last year.