CLL and MCL: Addressing the Knowledge Gaps in Treatment Strategies

Identifying Knowledge Gaps in CLL and MCL Treatment

A survey has uncovered concerning knowledge gaps in the treatment of refractory/relapsed chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL) among physicians in Germany, France, and the US. New oral targeted therapies, like Bruton tyrosine kinase inhibitors (BTKi), have been introduced, but many physicians are not adept in applying appropriate diagnostic methods and treatment plans.

Key Areas of Educational Need

• Importance of knowledge about treatment guidelines.
• Skills needed for molecular testing to guide treatments.
• Using patient profiles for personalized treatment strategies.
• Balancing treatment risks with potential benefits.
• Enhancing patient-provider communication for shared decision-making.

Knowledge of Treatment Guidelines

Physicians in France demonstrated knowledge of national guidelines on CLL and MCL, yet gaps were evident in understanding guidelines from prominent organizations, such as ESMO and EHA. In contrast, physicians in German academic settings showed stronger knowledge. Only 79% of physicians chose molecular testing for CLL progression cases, while a significant percentage still opted for non-guideline-compliant treatments.

Importance of Molecular Testing

Significant gaps emerged regarding molecular testing, with providers acknowledging a lack of understanding about critical tests like del17p and TP53. Shockingly, 66% had inadequate knowledge of PLCG2 testing implications.

Evaluating Treatment Decisions through Patient Profiles

Concerningly, 27% of physicians reported insufficient knowledge in determining which patients required molecular testing. Additionally, more than one-third exhibited a lack of skill in evaluating the risks associated with BTKi treatments.

Proposed Solutions for Improvement

This study highlights severe knowledge deficiencies in hematologists and suggests implementing continuing medical education, particularly focused on enhancing guidelines and molecular test understanding among community-based and less experienced physicians.