Oncotarget

Research Papers:

The experiences and needs of Australian medical oncologists in integrating comprehensive genomic profiling into clinical care: a nation-wide survey

Subotheni Thavaneswaran _, Mandy Ballinger, Phyllis Butow, Bettina Meiser, David Goldstein, Frank Lin, Christine Napier, David Thomas and Megan Best

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Oncotarget. 2021; 12:2169-2176. https://doi.org/10.18632/oncotarget.28076

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Abstract

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

Correspondence to:

Subotheni Thavaneswaran, email: [email protected]

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

Copyright: © 2021 Thavaneswaran et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

ABSTRACT

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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