Abstract
Background: Next-generation sequencing (NGS) has expanded the identification of genomic biomarkers to inform treatment selection and is increasingly performed on circulating tumor DNA (ctDNA) via liquid biopsy (LB). It is essential for oncology advanced practitioners (APs) to properly identify patients to undergo biomarker testing and accurately interpret results for patient care. We describe the implementation and impact of a case-based learning (CBL) education program for APs focused on LB-based biomarker testing. Methods: A pre/post design was used to evaluate APs participating in interactive CBL sessions focused on LB utility at diagnosis, disease progression, and treatment monitoring. Surveys administered immediately before and after education captured biomarker testing practices, clinical indications for LB, and confidence identifying patients and interpreting results. Statistical analyses included chi-square and paired t-tests (p < .05). Results: A total of 106 participants from more than 15 institutions completed paired surveys. Baseline practices for biomarker testing most commonly included tissue-first with reflex to LB or concurrent testing. After education, 50% of APs reported they would consider LB use for expanded clinical indications. All cohorts demonstrated statistically significant improvements in confidence identifying appropriate patients and interpreting or explaining LB-based comprehensive genomic profiling results (p < .01), with the greatest gains among APs with 0 to 3 years of experience. Nearly all participants (97%) felt confident identifying patients eligible for liquid biopsy post-education. Conclusion: Peer-developed CBL significantly improved AP confidence and understanding of LB-based biomarker testing. Integrating structured, AP-led education into oncology training may enhance precision oncology practice and support guideline-aligned patient care.
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