Advanced cancer patients’ attitudes towards, and experiences with, screening for somatic mutations in tumours: a qualitative study

Abstract

Somatic mutations in key oncogenes in non-small cell lung cancer (NSCLC) and melanoma are important determinants of tumour sensitivity to targeted therapies. Molecular screening for these predictive biomarkers is routinely used to inform treatment decisions; however, little is known about how best to communicate testing and results to patients. This qualitative study aimed to explore advanced cancer patients' attitudes and experiences regarding somatic tumour screening to identify their information and support needs. Sixteen NSCLC and eight melanoma patients who had undergone screening participated in a semi-structured face-to-face or telephone interview exploring their understanding, views, preferences and needs regarding screening. Interviews were audiotaped, transcribed and analysed for thematic patterns. Participants expressed positive views and unequivocal acceptance of screening, and understood its role in guiding treatment selection. They preferred to receive information verbally through simple, non-technical language from their oncologist with additional take-home materials. Patients were interested in learning about their test results, but wanted discussion to be focused on practical matters relevant to treatment. While receiving their screening results was not considered burdensome, information overload and cancer-related distress were identified as barriers to test comprehension. Patients may benefit from information and decision-related tools to better understand genomic information and adequately support psychosocial outcomes.

Understanding and information needs of cancer patients regarding treatment‐focused genomic testing: A systematic review

“…The qualitative studies were published between 2011 and 2017 from Australia (n = 2), USA (n = 2), and France (n = 1). Four out of five qualitative studies explored information and communication needs regarding treatment‐focused genomic testing of patients diagnosed with various types of cancer such as ovarian, gastrointestinal, breast, lung, as well as melanoma. Three studies examined patients' knowledge and understanding of genomic testing and its implication on cancer treatment .…”

“…Four out of five qualitative studies explored information and communication needs regarding treatment‐focused genomic testing of patients diagnosed with various types of cancer such as ovarian, gastrointestinal, breast, lung, as well as melanoma. Three studies examined patients' knowledge and understanding of genomic testing and its implication on cancer treatment . One study focused specifically on the understanding and helpfulness of metaphors used by oncologists to explain genomic testing to cancer patients .…”

“…The number of individuals participating in the qualitative studies ranged from 22 to 66. All the qualitative studies were cross‐sectional in nature and adopted either thematic content analyses or grounded theory to analyze the data …”

“…Although most cancer patients had heard about genomic testing and its implication for precision oncology, in some studies less than half of them were able to provide accurate and comprehensive definitions by linking genomic testing with the analysis of mutations in DNA, which could be targeted by drugs . In two studies, most patients associated genomic testing exclusively with cancer susceptibility and familial risk without acknowledging its impact on informing cancer treatment .…”

“…In two studies, most patients associated genomic testing exclusively with cancer susceptibility and familial risk without acknowledging its impact on informing cancer treatment . One in five patients in a single‐study understood genomic testing as a biopsy that could identify type of cancer and cancer‐specific treatment, while 38% of patients loosely associated genomic testing with accessibility of targeted therapies . Interestingly, one study found that nearly all patients reported understanding the explanation about somatic and germline testing provided to them by their doctors, however, we appreciate that this may not be representative of the general experience .…”