Attitudes toward molecular testing for personalized cancer therapy

Yusuf, Rafeek A.; Rogith, Deevakar; Hovick, Shelly R.; Peterson, Susan K.; Burton-Chase, Allison M.; Fellman, Bryan; Li, Yisheng; McKinney, Carolyn; Bernstam, Elmer V.; Meric‐Bernstam, Funda

doi:10.1002/cncr.28966

Cited by 47 publications

(64 citation statements)

References 38 publications

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“…This was a cross-sectional survey with conventional sampling. These questions were part of a larger questionnaire and focused on demographics, definitions, expectations and knowledge about research [24, 25]. The knowledge questionnaire included 16 questions each of which could be answered “True”, “False” or “Do not know” (Supplementary Document 1).…”

Section: Methodsmentioning

confidence: 99%

“…The information-seeking questionnaire contained multiple-choice questions that assessed where participants looked for information and how they used the information that they found. Additional questions assessed attitudes regarding privacy of genomic information and research participation [24, 25]. We recorded participants’ age, insurance, and clinical variables such as duration of illness, cancer stage, history of cancer therapy, history of genetic testing, and consent for tissue banking from the participants’ medical records.…”

Section: Methodsmentioning

confidence: 99%

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Patient knowledge and information-seeking about personalized cancer therapy

Rogith¹,

Yusuf²,

Hovick

et al. 2016

International Journal of Medical Informatics

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Background Understanding patients’ knowledge and prior information-seeking regarding personalized cancer therapy (PCT) may inform future patient information systems, consent for molecular testing and PCT protocols. We evaluated breast cancer patients’ knowledge and information-seeking behaviors regarding PCT. Methods Newly registered female breast cancer patients (n=100) at a comprehensive cancer center completed a self-administered questionnaire prior to their first clinic visit. Results Knowledge regarding cancer genetics and PCT was moderate (mean 8.7 +/− 3.8 questions correct out of 16). A minority of patients (27%) indicated that they had sought information regarding PCT. Higher education (p=0.009) and income levels (p=0.04) were associated with higher knowledge scores and with seeking PCT information (p=0.04). Knowledge was not associated with willingness to participate in PCT research. Conclusion Educational background and financial status impact patient knowledge as well as information-seeking behavior. For most patients, clinicians are likely to be patients’ initial source of information about PCT. Understanding patients’ knowledge deficits at presentation may help inform patient education efforts.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Patient knowledge and information-seeking about personalized cancer therapy

Rogith¹,

Yusuf²,

Hovick

et al. 2016

International Journal of Medical Informatics

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“…3,19,22 Our participants were mostly Caucasian, spoke English, were well-educated, and identified with no religion or were Christian. Although there were no differences between participants and non-respondents, our study did have a low response rate.…”

Section: Limitationsmentioning

confidence: 99%

“…11 The potential psychological impacts, along with concerns regarding family planning, fertility, lifestyle choices and health management, 5,12 indicate individualized management and genetic counseling should remain a priority. 3,10 A large body of research has investigated public [13][14][15][16][17] and patient 1,3,[18][19][20][21][22] perceptions of genetic testing, and reported that despite low levels of understanding, perceived benefits outweigh the risks. Patients' most highly-rated benefits include increased knowledge, better outcomes, and more effective prevention strategies.…”

Section: Introductionmentioning

confidence: 99%

Genetic testing for the risk of developing late effects among survivors of childhood cancer: Consumer understanding, acceptance, and willingness to pay

Georgiou

Wakefield

McGill

et al. 2016

Cancer

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BACKGROUND Genetic testing to determine cancer survivors' risk of developing late effects from their cancer treatment will be increasingly used in survivorship care. This 2‐stage study with 64 survivors of childhood cancer and their parents investigated the preferences and acceptability of testing among those who may be at risk of developing late effects. METHODS The first stage (Stage 1) identified the most commonly perceived benefits and concerns regarding genetic testing for the risk of late effects among 24 participants. In Stage 2, during interviews, 20 survivors (55% of whom were female; mean age, 26.0 years [range, 18‐39 years]; standard deviation [SD], 0.80) and 20 parents (55% of whom were male; mean age of child survivor, 14.2 years [range, 10‐19 years]; SD, 0.79) rated the 7 most common benefits and concerns from those identified in Stage 1. Interviews were transcribed verbatim and analyzed. Decisional balance ratios were calculated by dividing the participants' average concerns scores with the average benefits scores. RESULTS Genetic testing for late effects was highly acceptable: 95% of participants leaned toward testing, and the majority (65.9%) would pay up to Australian $5000. The majority (97.2%) reported it was acceptable to wait for up to 6 months to receive results, and to be offered testing immediately after treatment or when the survivor reached adulthood (62.9%). Survivors and parents had a highly positive decisional balance (Mean (M), 0.5 [SD, 0.38] and M, 0.5 [SD, 0.39], respectively), indicating that perceived benefits outweighed concerns. CONCLUSIONS Although to our knowledge clinical efficacy has yet to be clearly demonstrated, survivors and parents described positive interest in genetic testing for the risk of developing late effects. Perceived benefits outweighed harms, and the majority of participants would be willing to pay, and wait, for testing. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2876–2885. © 2016 American Cancer Society

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“…Including but not being limited to learning the new assay, validating the tests and training personnel, healthcare centers must examine FDA and clinically approved regulations, insurance policies, and cost-efficiency strategies. In a recent paper, overall patients were more willing to undergo molecular testing if it is an approved therapy and is covered by insurance (11). Healthcare centers need to relay all the valuable outcomes of testing with an NGS assay to their patients to eliminate the possibility of uncertainty.…”

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confidence: 99%

Next-Generation Sequencing: Targeting Targeted Therapies

McCutcheon

Giaccone

2015

Clinical Cancer Research

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Next-generation sequencing (NGS) has given new perspective in oncology. With the ongoing development of targeted therapies, NGS is evolving molecular diagnostics by providing comprehensive interrogation of clinically actionable genomic aberrations in tumors. Having this assay as the primary testing method produces clinically beneficial results. See related article by Drilon et al., p. 3631 In this issue of Clinical Cancer Research, Drilon and colleagues (1) demonstrate the significant role of next-generation sequencing (NGS) as the primary testing method in molecular diagnostics. Thirty one previously tested lung adenocarcinoma patients assessed by single non-NGS molecular tests, such as fluorescence in situ hybridization (FISH), multiplex mass spectrometry, and sizing assays, produced "negative" results for known lung adenocarcinoma genomic alterations in the genes EGFR, ERBB2, KRAS, NRAS, BRAF, MAP2K1, PIK3CA, AKT1, ALK, ROS1, and RET. By retesting these patients with a broad, hybrid capturebased NGS assay, Drilon and colleagues (1) revealed actionable genomic alterations present in 65% of the patients that were formerly deemed "driver negative." NGS technologies are rapidly evolving and are being increasingly used in research settings as well as clinical settings, to replace older and less-sensitive technologies. As opposed to classic Sanger sequencing, NGS technology uses clonally amplified or singlemolecule templates that are sequenced in a massively parallel fashion, allowing examination of numerous amounts of large protein coding regions, which makes NGS assays suitable for a comprehensive interrogation of cancer drivers (2). Whereas current non-NGS tests mostly examine only one variant type, NGS technology allows the patient's tumor to be tested in a single run for all types of variants, including single-nucleotide variations (SNV), insertions, deletions, exon duplications, gene copy number changes, and known translocations (3).In recent years, the advancement of NGS technology in the clinical setting has been rapidly progressing and will soon likely replace older technologies. Lung cancer, the leading cause of cancer-related death in the world, comprises a complex mutational spectrum, and the discoveries of many oncogenic drivers in the tumors have led to the development and evolution of targeted therapy, especially in the adenocarcinoma of the lung, the most prevalent type of lung cancer (4, 5). Among these targeted therapies are the tyrosine kinase inhibitors (TKI); the FDA approved TKIs in lung adenocarcinoma treatment to target EGFR and ALK. Sensitizing mutations and rearrangements in the EGFR and ALK genes, respectively, are responsible for the constitutively activated kinase, and render tumors exquisitely sensitive to TKIs. In the case of EGFR and ALK inhibitors, response rates and progression-free survival are dramatically improved compared with standard chemotherapy (6). Although TKIs are initially very effective in the majority of patients whose tumors harbor the genetic alteration, acquired...

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Attitudes toward molecular testing for personalized cancer therapy

Cited by 47 publications

References 38 publications

Patient knowledge and information-seeking about personalized cancer therapy

Patient knowledge and information-seeking about personalized cancer therapy

Genetic testing for the risk of developing late effects among survivors of childhood cancer: Consumer understanding, acceptance, and willingness to pay

Next-Generation Sequencing: Targeting Targeted Therapies

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