Advanced Cancer Patient Knowledge of and Attitudes towards Tumor Molecular Profiling

Davies, Grace; Butow, Phyllis; Napier, Christine E.; Bartley, Nicci; Juraskova, Ilona; Meiser, Bettina; Ballinger, Mandy L.; Thomas, David M.; Schlub, Timothy E.; Best, Megan

doi:10.1016/j.tranon.2020.100799

Cited by 10 publications

(9 citation statements)

References 38 publications

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“…For a significant minority of patients surveyed, barriers to undergoing tumor NGS included the need for a biopsy [12], cost [9], and, for a small minority, worries about information privacy [21].…”

Section: Discussionmentioning

confidence: 99%

“…Table 1 includes three publications [7][8][9] from a single survey of 100 patients with breast cancer recruited during their first visit to the University of Texas MD Anderson Cancer Center who were asked to provide consent for tissue banking. Table 2 includes three publications [10][11][12] from the Psychosocial Issues in Genomics in Oncology (PiGeOn) Project, a substudy of the Molecular Screening and Therapeutics Program in Sydney, Australia, which provided tumor molecular profiling to 1,000 patients with advanced cancer for whom there are no further therapeutic options. Table 2 also includes two publications by Blijsma et al [13,14] who interviewed patients (twice) regarding attitudes toward secondary germline findings from tumor NGS and then, shortly thereafter, conducted a third set of more in-depth interviews with the same patients, summarized in a separate publication.…”

Section: Patientsmentioning

confidence: 99%

“…Objectively Assessed Knowledge. In five of six studies that objectively assessed patients' knowledge of somatic testing (Tables 1 and 2), patients generally had moderate to poor knowledge of this concept, with the majority unaware of the distinction between somatic and germline testing [7,12,16,19,20]. Several of the validated questionnaires used in these studies had more questions about germline testing than about somatic testing, which may in some cases have added to the confusion.…”

Section: Knowledgementioning

confidence: 99%

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Patients’ and Oncologists’ Knowledge and Expectations Regarding Tumor Multigene Next-Generation Sequencing: A Narrative Review

et al. 2021

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Background. Tumor multigene next-generation sequencing (NGS) is increasingly being offered to cancer patients to guide clinical management and determine eligibility for clinical trials. We undertook a review of studies examining the knowledge and attitudes of patients and oncologists regarding the primary results and potential secondary findings of such testing. Materials and Methods. A search was conducted through the MEDLINE database using the following keywords: "neoplasms" and "molecular sequencing / genome sequencing / tumor profiling / NGS / whole exome sequencing" and "patient / oncologist" and "knowledge / attitudes / satisfaction / experience / evaluation / perspective / practice / preference." Articles meeting the inclusion criteria and additional relevant articles from their references were selected. Results. From 1,142 publications identified by the search and 9 from references, 21 publications were included in the final review. Patients generally had positive attitudes

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Section: Discussionmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

Section: Knowledgementioning

confidence: 99%

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Patients’ and Oncologists’ Knowledge and Expectations Regarding Tumor Multigene Next-Generation Sequencing: A Narrative Review

et al. 2021

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“…Several studies suggest that patients with advanced cancer have poor genetic knowledge and understanding of the difference between tumor and germline testing and high Cancer April 1, 2022 expectations of benefit. [8][9][10][11][12] Qualitative studies have reported patient disappointment, distress, and loss of hope after tumor genetic testing. 10,12 This suggests a need for improved pretest education for tumor genetic testing to align expectations and improve patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…10,12 This suggests a need for improved pretest education for tumor genetic testing to align expectations and improve patient outcomes. [9][10][11] The limited workforce of genetic providers and the time sensitivity of results for treatment planning require novel and timely genetic delivery strategies to deliver patientcentered, high-quality precision oncology care.…”

Section: Introductionmentioning

confidence: 99%

A randomized study of genetic education versus usual care in tumor profiling for advanced cancer in the ECOG‐ACRIN Cancer Research Group (EAQ152)

Bradbury

Lee

Gaieski

et al. 2021

Cancer

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BACKGROUND: Enthusiasm for precision oncology may obscure the psychosocial and ethical considerations associated with the implementation of tumor genetic sequencing. METHODS: Patients with advanced cancer undergoing tumor-only genetic sequencing in the National Cancer Institute Molecular Analysis for Therapy Choice (MATCH) trial were randomized to a web-based genetic education intervention or usual care. The primary outcomes were knowledge, anxiety, depression, and cancer-specific distress collected at baseline (T0), posteducation (T1) and after results (T2). Two-sided, 2-sample t tests and univariate and multivariable generalized linear models were used. RESULTS: Five hundred ninety-four patients (80% from NCI Community Oncology Research Program sites) were randomized to the web intervention (n = 293) or usual care (n = 301) before the receipt of results. Patients in the intervention arm had greater increases in knowledge (P for T1-T0 < .0001; P for T2-T0 = .003), but there were no significant differences in distress outcomes. In unadjusted moderator analyses, there was a decrease in cancer-specific distress among women (T0-T1) in the intervention arm but not among men. Patients with lower health literacy in the intervention arm had greater increases in cancer-specific distress and less decline in general anxiety (T0-T1) and greater increases in depression (T0-T2) in comparison with those receiving usual care. CONCLUSIONS: Web-based genetic education before tumor-only sequencing results increases patient understanding and reduces distress in women. Refinements to the intervention could benefit low-literacy groups and men.

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Psychological predictors of advanced cancer patients’ preferences for return of results from comprehensive tumor genomic profiling

Meiser

Butow

Davies

et al. 2021

American J of Med Genetics Pt A

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This study assessed the psychological predictors of preferences for return of comprehensive tumor genomic profiling (CTGP) results in patients with advanced cancers, enrolled in the Molecular Screening and Therapeutics Program. Patients completed a questionnaire prior to undergoing CTGP. Of the 1434 who completed a questionnaire, 96% would like to receive results that can guide treatment for their cancer, and preference for receiving this type of result was associated with lower tolerance of uncertainty. Sixty-four percent would like to receive results that cannot guide treatment, and lower tolerance of uncertainty, self-efficacy, and perceived importance were associated with this preference. Fifty-nine percent would like to receive variants of unknown significance, which was associated with lower tolerance of uncertainty, higher self-efficacy, and perceived importance. Eighty-six percent wanted to receive germline results that could inform family risk. This was associated with higher self-efficacy, perceived importance, and perceived susceptibility. Although most patients wanted to receive all types of results, given the differing patient preferences regarding the return of results depending on the utility of the different types of results, it appears critical to safeguard patient understanding of result utility to achieve informed patient choices. This should be accompanied by appropriate consent processes.

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Advanced Cancer Patient Knowledge of and Attitudes towards Tumor Molecular Profiling

Cited by 10 publications

References 38 publications

Patients’ and Oncologists’ Knowledge and Expectations Regarding Tumor Multigene Next-Generation Sequencing: A Narrative Review

Patients’ and Oncologists’ Knowledge and Expectations Regarding Tumor Multigene Next-Generation Sequencing: A Narrative Review

A randomized study of genetic education versus usual care in tumor profiling for advanced cancer in the ECOG‐ACRIN Cancer Research Group (EAQ152)

Psychological predictors of advanced cancer patients’ preferences for return of results from comprehensive tumor genomic profiling

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