The experiences and needs of Australian medical oncologists in integrating comprehensive genomic profiling into clinical care: a nation-wide survey
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Subotheni Thavaneswaran1,2,3, Mandy Ballinger1,3, Phyllis Butow4, Bettina Meiser5, David Goldstein5, Frank Lin1,3, Christine Napier1, David Thomas1,2,3 and Megan Best6
1 Garvan Institute of Medical Research, Darlinghurst, NSW 2010, Australia
2 The Kinghorn Cancer Centre, St Vincent’s Hospital, Darlinghurst, NSW 2010, Australia
3 St Vincent’s Clinical School, University of NSW, Darlinghurst, NSW 2010, Australia
4 School of Psychology, Psycho-Oncology Co-Operative Research Group (PoCoG), The University of Sydney, Sydney, NSW 2006, Australia
5 Prince of Wales Clinical School, University of NSW, Sydney, NSW 2052, Australia
6 Institute for Ethics and Society, University of Notre Dame Australia, Sydney, NSW 2007, Australia
Keywords: comprehensive genomic profiling; precision medicine; targeted treatment selection using genomics; communication; clinicians' experiences with utilising genomic findings in a pan-cancer setting to inform treatment selection
Received: July 17, 2021 Accepted: September 04, 2021 Published: October 12, 2021
Purpose: Comprehensive genomic profiling (CGP) is increasingly used to guide cancer therapy. This study aimed to characterise oncologists’ experiences and needs when utilising genomic results.
Materials and Methods: An electronic survey distributed nation-wide to practising medical oncologists in Australia explored oncologists’ experiences with consenting, interpreting and communicating CGP results to patients.
Results: The survey was completed by 108 of 333 oncologists (32%) and most respondents (n = 97, 90%) had referred patients for CGP. Using a 100-point visual analogue scale score [VAS], where higher values indicate greater confidence, most oncologists were confident consenting patients for referral [median 75 (Interquartile range, IQR: 53–85), discussing CGP results (median VAS: 70, IQR: 51–80), but significantly less confident discussing secondary germline findings (median VAS: 56, IQR 30–70, p < 0.001). Confidence with pursuing therapies based on CGP results increased with clinical experience (mean VAS increases by 4.8 per 5 years of experience, p < 0.001). Most oncologists (N = 68, 63%) reported wanting assistance with interpretation of CGP and patient-centric resources to aid communication with patients.
Conclusions: Oncologists are integrating genomics into clinical care, but only display moderate confidence in communication and changing management accordingly. The development of patient- and clinician- targeted resources may assist with routine utilisation of CGP results in cancer care.
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