Comparison of quantitative disease resistance loci (QDRL) towards the diverse array of soilborne pathogens that affect soybean [Glycine max (L.) Merr.] is key to the incorporation of resistance in breeding programs. The water molds Phytophthora sojae (Kauffman & Gerdmann), Pythium irregulare (Buisman), Pythium ultimum var. ultimum (Trow), and Pythium ultimum var. sporangiiferum (Drechsler) contribute to soybean yield losses annually. Six Soybean Nested Association Mapping (SoyNAM) populations were evaluated for resistance to one or more of these pathogens. Four were screened with a tray test to measure lesion length after inoculation with Ph. sojae; cup assays were used to screen three, three, and two populations for resistance towards Py. irregulare, Py. ultimum var. ultimum, and Py. ultimum var. sporangiiferum, respectively. There were two to eight major or minor QDRL identified within each SoyNAM population towards one or more of these water molds for a total of 33 QDRL. The SoyNAM populations evaluated for resistance to two or more water molds had different QDRL towards each pathogen, indicating that within a source of resistance, mechanisms are potentially specific to the pathogen. Only 3 of the 33 QDRL were associated with resistance to more than one pathogen. There was a major QDRL on chromosome 3 associated with resistance to Py. ultimum var. ultimum and Py. ultimum var. sporangiiferum, and QDRL on chromosomes 13 and 17 shared a flanking marker for both Py. irregulare and Py. ultimum var. ultimum. The SoyNAM population can serve as a diverse resource to map QDRL and compare mechanisms across pathogens and isolates.

Phytophthora sojae causes Phytophthora root and stem rot of soybean and has been primarily managed through deployment of qualitative Resistance to P. sojae genes (Rps genes). The effectiveness of each individual or combination of Rps gene(s) depends on the diversity and pathotypes of the P. sojae populations present. Due to the complex nature of P. sojae populations, identification of more novel Rps genes is needed. In this study, phenotypic data from previous studies of 16 panels of plant introductions (PIs) were analyzed. Panels 1 and 2 consisted of 448 Glycine max and 520 G. soja, which had been evaluated for Rps gene response with a combination of P. sojae isolates. Panels 3 and 4 consisted of 429 and 460 G. max PIs, respectively, which had been evaluated using individual P. sojae isolates with complex virulence pathotypes. Finally, Panels 5–16 (376 G. max PIs) consisted of data deposited in the USDA Soybean Germplasm Collection from evaluations with 12 races of P. sojae. Using these panels, genome‐wide association (GWA) analyses were carried out by combining phenotypic and SoySNP50K genotypic data. GWA models identified two, two, six, and seven novel Rps loci with Panels 1, 2, 3, and 4, respectively. A total of 58 novel Rps loci were identified using Panels 5–16. Genetic and phenotypic dissection of these loci may lead to the characterization of novel Rps genes that can be effectively deployed in new soybean cultivars against diverse P. sojae populations.

PURPOSE: Tumor genomic testing (TGT) has become increasingly adopted as part of standard cancer care for many cancers. Despite national guidelines around patient education before TGT, available evidence suggests that most patients' understanding of genomics remains limited, particularly lower-income and minority patients, and most patients are not informed regarding potential incidental germline findings. METHODS: To investigate and address limitations in patient understanding of TGT results, a Plan-Do-Study-Act (PDSA) approach is being used to assess needs, identify opportunities for improvement, and implement approaches to optimize patient education. We reviewed published guidelines related to pre-TGT provider-patient education and to identify key points (Plan). A provider quality improvement survey was completed (Do), which highlighted inconsistency in pre-TGT discussion practice across providers and minimal discussion with patients regarding the possibility of incidental germline findings. RESULTS: Patient focus groups and interviews (N = 12 patients) were completed with coding of each transcript (Study), which revealed themes including trouble differentiating TGT from other forms of testing, yet understanding that results could tailor therapy. The integration of data across this initial PDSA cycle identified consistent themes and opportunities, which were incorporated into a patient-directed, concise animated video for pre-TGT education (Act), which will form the foundation of a subsequent PDSA cycle. The video addresses how TGT may/may not inform treatment, the process for TGT using existing tissue or liquid biopsy, insurance coverage, and the potential need for germline genetics follow-up because of incidental findings. CONCLUSION: This PDSA cycle reveals key gaps and opportunities for improvement in patient education before TGT.

Background: Tumor genomic testing (TGT) has become increasingly adopted as part of standard cancer care for many cancers. Despite national guidelines around patient education prior to TGT, available evidence suggests that most patients’ understanding of genomics remains limited, particularly lower income and minority patients, and most patients are not informed regarding potential incidental germline findings. Purpose: The primary object of this ongoing clinical trial is to evaluate the effectiveness of concise, animated videos to provide patient pre-test education prior to TGT as a supplement to patient-provider discussion. Trial Design: This prospective observational cohort study will enroll a total of 150 cancer patients in three clinical cohorts: Cohort 1: breast cancer (n=50); Cohort 2: lung cancer (n=50); Cohort 3: cancer patients of any tumor type (n=50). The primary objective is to assess change in patient knowledge of TGT following exposure to the video to evaluate the hypothesis that exposure to a brief educational video will increase patient knowledge about tumor genomic testing. Secondary objectives include assessing changes following exposure to the video, including: 1) genomic knowledge 2) trust in Physician 3) comparison of results between the three patient cohorts. Methods: Based on published guidelines around pre-TGT provider-patient education and patient focus groups and interviews, content for a series of videos was developed to standardize patient pretest education of TGT. A base animated video was created to be applicable to any cancer type; additional tumor type content was added for the breast and lung cancer-specific videos. Participant recruitment is occurring at The Ohio State University’s Comprehensive Cancer Center. Eligibility criteria include: age 18 years or older, biopsy-confirmed cancer, and provider plan to undergo TGT. This study requires participants to complete surveys at three timepoints: before video viewing (T1), immediately after video viewing (T2), and after provider communicates TGT results to the patient (T3). Four survey instruments are completed at T1/T2/T3: video message-specific recall, objective genomic knowledge/understanding, the 11-item Trust in Physician, and attitudes around genetic/genomic testing. TGT intention surveys are captured at T1 and T2. Participant evaluation of the video is collected at T2. For the primary objective, we will use a two-sided Wilcoxon signed-rank test with alpha of 0.05, giving us 90% power to detect an effect size of 0.47 in change of recall accuracy from pre- to post- video intervention. All secondary outcomes will be summarized using descriptive statistics and compared pre-/post-video using Wilcoxon signed-rank test. For comparisons of MBC and MLC, endpoints will include 1) baseline and pre-/post-video intervention change in genomic knowledge/understanding in MBC versus MLC patients; 2) baseline and pre-/post-video intervention change in trust in provider. The baseline and the change from pre- to post-video intervention in the secondary outcomes will be compared between MBC and MLC patients using Wilcoxon rank sum test. Conclusions: The long-term goal of this project is to test this broadly applicable, modular video-based intervention to be administered prior to tumor NGS to ensure equitable access to informed care. The use of a short video in this setting is innovative and we are demonstrating capacity to complete such a project. Study enrollment began March 30, 2022 and to date, 33 participants have enrolled (n=18 breast cancer; n=9 lung cancer; n=6 other cancer types). ClinicalTrials.gov NCT05215769. Citation Format: Daniel Stover, Deloris Veney, Heather Hampel, Amanda E. Toland, Carolyn Presley, Tasleem Padamsee, Clara Lee, Shelly Hovick, Leigha Senter. A Video Intervention to Improve Patient Understanding of Tumor Genomic Testing in Patients With Metastatic Cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT2-04-01.