The influence of gene expression profiling on decisional conflict in decision making for early-stage breast cancer chemotherapy

MacDonald, Karen V.; Bombard, Yvonne; Deal, Ken; Trudeau, Maureen; Leighl, Natasha B.; Marshall, Deborah A.

doi:10.1016/j.ejca.2016.03.077

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…In addition, we found that the percentage of patients who were initially unsure about treatment with adjuvant CT decreased from 42 to 5% after use of the 70-GS. These results complement previous findings evaluating the impact of GEP use on the shared decision-making process regarding adjuvant CT [21][22][23][24]. In a large prospective study conducted by Levine et al the impact of Oncotype Dx on the patient's CT preference was assessed in the same category of ER + /HER2-breast cancer patients and they reported a comparable 31% change in the patient's CT treatment choice following Oncotype Dx.…”

Section: Unsure N=3supporting

confidence: 84%

Patients’ perceptions of 70-gene signature testing: commonly changing the initial inclination to undergo or forego chemotherapy and reducing decisional conflict

Steenhoven

Dekker

Kuijer

et al. 2020

Breast Cancer Res Treat

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Purpose Little is known about the impact of 70-gene signature (70-GS) use on patients' chemotherapy decision-making. The primary aim of this study was to evaluate the impact of 70-GS use on patients' decisions to undergo chemotherapy. The perceived decision conflict during decision-making was a secondary objective of the study. Methods Patients operated for estrogen receptor positive early breast cancer were asked to fill out a questionnaire probing their inclination to undergo chemotherapy before deployment of the 70-GS test. After disclosure of the 70-GS result patients were asked about their decision regarding chemotherapy. Patients' decisional conflict was measured using the 16-item decisional conflict scale (DCS); scores < 25 are associated with a persuaded decision while a score > 37.5 implies that one feels unsure about a choice. Results Between January 1th 2017 and December 31th 2018, 106 patients completed both questionnaires. Before deployment of the 70-GS, 58% of patients (n = 62) formulated a clear treatment preference, of whom 21 patients (34%) changed their opinion on treatment with chemotherapy following the 70-GS. The final decision regarding chemotherapy was in line with the 70-GS result in 90% of patients. The percentage of patients who felt unsure about their preference to be treated with chemotherapy decreased from 42 to 5% after disclosure of the 70-GS. The mean total DCS significantly decreased from pre-test to post-test from 35 to 23, irrespective of the risk estimate (p < 0.001). Conclusion Deployment of the 70-GS changed patients' inclination to undergo adjuvant chemotherapy in one third of patients and decreased patients' decisional conflict.

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Section: Unsure N=3supporting

confidence: 84%

Patients’ perceptions of 70-gene signature testing: commonly changing the initial inclination to undergo or forego chemotherapy and reducing decisional conflict

Steenhoven

Dekker

Kuijer

et al. 2020

Breast Cancer Res Treat

View full text Add to dashboard Cite

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“…Yet, several studies highlighted the risk of over-reliance: some patients might believe that the genomic test is more important than clinical parameters and might rely only on it [ 125 , 126 ]. On the contrary, women who are confident about their treatment decisions might be unsettled in case of discordant result [ 127 ].…”

Section: How Do Gene Expression Signatures Influence Clinical Decisions?mentioning

confidence: 99%

Using Breast Cancer Gene Expression Signatures in Clinical Practice: Unsolved Issues, Ongoing Trials and Future Perspectives

Varnier

Sajous

Talhouet

et al. 2021

Cancers

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The development of gene expression signatures since the early 2000′s has offered standardized assays to evaluate the prognosis of early breast cancer. Five signatures are currently commercially available and recommended by several international guidelines to individualize adjuvant chemotherapy decisions in hormone receptors-positive/HER2-negative early breast cancer. However, many questions remain unanswered about their predictive ability, reproducibility and external validity in specific populations. They also represent a new hope to tailor (neo)adjuvant systemic treatment, adjuvant radiation therapy, hormone therapy duration and to identify a subset of patients who might benefit from CDK4/6 inhibitor adjuvant treatment. This review will highlight these particular issues, address the remaining questions and discuss the ongoing and future trials.

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Lessons Learned from a Cancer Knowledge Translation Grants Program: Results of an Evaluation

et al. 2019

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Background A novel way to build capacity in knowledge translation (KT) is through KT-focused grant competitions. Since 2009, the Knowledge Translation Research Network (KT-Net) has had a cancer-related KT grants program. We undertook an evaluation of the program to determine if KT-Net was achieving its aims of building capacity in cancer KT, advancing the science of KT, building partnerships, and leveraging funding.Methods An adapted framework guided the evaluation. Nine funded studies from 4 competitions were included. Semi-structured telephone interviews were held with researchers, stakeholders (including knowledge users), members of grant review panels, and experts in kt. Interview transcripts were audio-recorded, transcribed, and analyzed thematically. A review of proposal and report documents was also conducted.Results Funded researchers indicated that the grant competition was an essential funding program for cancer KT research. Competitions were perceived to build capacity in cancer KT among early-career researchers and to encourage innovative cancer KT research for which alternative funding sources are limited. The grants program resulted in incremental gains in advancing the science of kt. Suggestions to improve the program included stronger partnerships between the funder and the provincial cancer-system organization to optimize the application of research that is relevant to the organization’s strategic objectives.Conclusions The grants program met many of its aims by providing cancer researchers with an opportunity to gain capacity in cancer KT and by making incremental advances in KT science. Suggestions to improve the program included closer partnerships between the funder and the cancer-system organization.

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The influence of gene expression profiling on decisional conflict in decision making for early-stage breast cancer chemotherapy

Cited by 3 publications

References 32 publications

Patients’ perceptions of 70-gene signature testing: commonly changing the initial inclination to undergo or forego chemotherapy and reducing decisional conflict

Patients’ perceptions of 70-gene signature testing: commonly changing the initial inclination to undergo or forego chemotherapy and reducing decisional conflict

Using Breast Cancer Gene Expression Signatures in Clinical Practice: Unsolved Issues, Ongoing Trials and Future Perspectives

Lessons Learned from a Cancer Knowledge Translation Grants Program: Results of an Evaluation

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