Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Advanced cancer patient preferences for return of molecular profiling results (#101)

Megan Best 1 2 3 , Phyllis Butow 1 2 , Ilona Juraskova 1 , Jacqueline Savard 4 , Bettina Meiser 5 , David Goldstein 5 , Mandy Ballinger 6 , Chris Jacobs 7 , Nicci Bartley 1 , Grace Davies 1 , David Thomas 6 , Barbara Biesecker 8 , Kathy Tucker 5 , Timothy E Schlub 1 , Ainsley Newson 1
  1. Univeristy of Sydney, Camperdown, NSW, Australia
  2. The Psycho-oncology Cooperative Research Group, Univeristy of Sydney, Sydney, NSW, Australia
  3. Sydney Health Ethics, Sydney, NSW, Australia
  4. Deakin University, Geelong, Victoria, Australia
  5. UNSW, Sydney, NSW, Australia
  6. Garvan Institute of Medical Research, Sydney, NSW, Australia
  7. University of Technology, Sydney, NSW, Australia
  8. RTI International, Washington D.C., United States of America

Aims

Research evidence is mixed regarding cancer patient preferences for receiving tumour molecular profiling (MP) results. This study aimed to discern preferences for return of MP results in patients who have recently agreed to undergo genomic testing.

Methods

We conducted a mixed-methods study to explore cancer patients’ views on which MP results they would like to receive. The planned accrual target was reached with 1299 advanced cancer patients undergoing MP and completing questionnaires at the time of consent. A subset of patients (n=20) participated in semi-structured interviews which underwent thematic analysis.

Results

Response rate was 92%. Most (96%) participants wanted to receive MP results that could guide further treatment for their advanced cancer. Sixty-four percent wanted to access MP results which would not inform treatment, and 60% wanted to learn about  germline findings. Participants with children (Exp(B) = 2.28: 95% CI, 1.09 to 4.76: p < .05) or with a first degree relative diagnosed with cancer (Exp(B) = 2.37: 95% CI, 1.17 to 4.80: p < .05) were more likely to want to be informed about gene variants that can guide treatment. In terms of being informed about gene variants that cannot guide treatment, rural/remote patients were more likely than urban patients to want these results ((Exp(B) = 0.45: 95% CI, 0.28 to 0.72: p < .01)).

Two main themes were identified in the interview transcripts: 1) ‘Cancer is the focus’, which conveyed the priority of identifying therapies and fear of non-findings, and 2) ‘Trust in clinicians’, where participants relied on their clinicians to manage the process.

Conclusions

The majority of advanced cancer patients undergoing MP prioritised results which would lead to treatment options and trusted their oncologists to help them navigate the results return process. Concerns were related to receipt of non-findings.