Please use this identifier to cite or link to this item:
https://repository.monashhealth.org/monashhealthjspui/handle/1/35073
Conference/Presentation Title: | Evaluating barriers to uptake of comprehensive genomic profiling (CGP) in advanced cancer patients (pts). | Authors: | Martyn M.;Solomon B.J.;Tran B.;Scott C.L.;Kee D.;McArthur G.A.;Fellowes A.;Weerasuriya R.;Lynch E.;Gaff C.;Desai J.;Fox S.B.;Smith K.M.;Haire S.O.;Khuong-Quang D.A.;Markman B.;Gan H.K.;Ekert P.G.;O'Byrne K.J.;Millward M. | Institution: | (Smith, Haire, Khuong-Quang, Markman, Gan, Ekert, O'Byrne, Millward, Solomon, Tran, Scott, Kee, McArthur, Fellowes, Weerasuriya, Lynch, Martyn, Gaff, Fox, Desai) Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Peter MacCallum Cancer Centre, Melbourne, Australia; Monash Health and Monash University, Melbourne, Australia; Olivia Newton-John Cancer Research Institute, Victoria, NSW, Australia; Royal Children's Hospital, Parkville, VIC, Australia; Princess Alexandra Hospital, Brisbane, Australia; School of Medicine and Pharmacology, Nedlands, WA, Australia; Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia; Melbourne Genomics Health Alliance, Melbourne, VIC, Australia | Presentation/Conference Date: | 14-Sep-2020 | Copyright year: | 2020 | Publisher: | American Society of Clinical Oncology | Publication information: | Journal of Clinical Oncology. Conference: 2020 Annual Meeting of the American Society of Clinical Oncology, ASCO 2020. Chicago, IL United States. 38 (15) (no pagination), 2020. Date of Publication: 2020. | Journal: | Journal of Clinical Oncology | Abstract: | Background: Despite increasing evidence of benefit supporting CGP in personalizing cancer therapy, its widespread uptake remains limited. Barriers include low patient understanding, unmet patient expectations related to low utility, clinician concerns over cost-effectiveness, perceived value, and discomfort in management of complex genomic results. Method(s): This prospective cross-institutional demonstration study was designed to evaluate implementation of CGP in the care of adult and paediatric advanced cancer pts, incorporating pt reported outcomes (PROMs), discrete choice experiment (DCE), ongoing process optimization and clinician evaluations. DNA sequencing of FFPE tumor and matched blood was completed with CGP (PMCC Comprehensive Cancer Panel; 391 genes) via central laboratory. A tumor board reported results weekly with emphasis on therapeutic relevance. Oncologists performed consent and results delivery. Pts completed pre-and post-test surveys, including validated and study-specific questions, DCE and if eligible, semi-structured interviews. Qualitative interviews were undertaken with study clinicians and laboratory staff to evaluate processes. Result(s): 86% (315) of 365 enrolled pts had successful CGP; of these 63% (199) had relevant therapeutic, diagnostic or germline results. 50 (16%) had treatment change at 6m, 49 (16%) had germline mutations. 293 (88% of adult pts) completed PROMs. 17 of 19 clinicians/laboratory staff approached consented to an interview. At consent pts cited multifaceted value in testing, showed good understanding of basic concepts, but most (69%) overestimated the likelihood of result-led change. Post-test pts remained consistently satisfied with accessing CGP; valuing research contribution, taking opportunities and information for family. 21% struggled with understanding results but there were low levels of decisional regret following participation (89% had nil/mild regret). Pt-elicited preferences (via DCE) indicated priority for high rates of clinical utility and timeliness. Clinicians sited collaboration and communication as critical to delivery of CGP. Conclusion(s): Pts undergoing CGP are generally satisfied, and derive value on its use beyond potential therapeutic benefit. Our results suggest that to improve test utility and delivery of CGP with value to pts and investing institution, focus must be placed on addressing the additional barriers to its wider implications including efforts to improve process efficiencies, clinician genomic literacy and decision-making support. | Conference Start Date: | 2020-05-29 | Conference End Date: | 2020-06-02 | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1200/JCO.2020.38.15_suppl.2033 | ISSN: | 1527-7755 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/35073 | Type: | Conference Abstract | Subjects: | semi structured interview adult *advanced cancer *cancer patient child conference abstract controlled study decision making DNA sequencing female germ line human human cell human tissue literacy major clinical study male oncologist pretest posttest design process optimization prospective study *protein fingerprinting staff semi structured advanced cancer cancer patient decision making DNA sequencing germ line literacy oncologist pretest posttest design process optimization protein fingerprinting staff DNA sequencing female germ line pretest posttest design process optimization prospective study *protein fingerprinting semi structured interview staff human tissue human adult *advanced cancer *cancer patient child conference abstract controlled study decision making male major clinical study literacy human cell oncologist |
Appears in Collections: | Conferences |
Show full item record
Items in Monash Health Research Repository are protected by copyright, with all rights reserved, unless otherwise indicated.