image: Steps followed by oncologists in the clinical integration of genomic information and resources used or sought. Abbreviations: CGP: comprehensive genomic profiling, DTC: direct to consumer; FCC: Family Cancer Centre; MTB: molecular tumor board. view more
Credit: Correspondence to - Subotheni Thavaneswaran - s.thavaneswaran@garvan.org.au
Oncotarget published "The experiences and needs of Australian medical oncologists in integrating comprehensive genomic profiling into clinical care: a nation-wide survey" which reported that this study aimed to characterise oncologists' experiences and needs when utilising genomic results.
An electronic survey distributed nation-wide to practising medical oncologists in Australia explored oncologists' experiences with consenting, interpreting and communicating comprehensive genomic profiling (CGP) results to patients. The survey was completed by 108 of 333 oncologists and most respondents 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, discussing CGP results, but significantly less confident discussing secondary germline findings.
Dr. Subotheni Thavaneswaran said, "Medical oncologists were among the first clinicians to integrate genomics into clinical care."
Traditionally, this involved single gene testing or small gene panels in select cancer histotypes with established predictive, prognostic or therapeutic implications. The implementation of comprehensive genomic profiling has however been much more complex, with most gene panels comprised of hundreds of genes and applied to populations unselected by cancer type. The interpretation and management of germline findings outside a classic familial cancer context creates new challenges for oncologists, patients and their families.
Understanding oncologists' perspectives on their role and needs when communicating results to patients is important to the successful integration of CGP into routine care. The uptake of CGP was greatest in high-patient volume and academic centres and amongst clinicians with training in genomics. In an Australian context, the Australian Pancreatic Genome Initiative published a practical framework for communicating genomic research results, including informed consent, analytical validity, clinical relevance of results and results communication.
The Thavaneswaran Research Team concluded in their Oncotarget Research Output, "this study provides insight into how Australian oncologists are coping in the era of precision medicine, and their perceptions of potential barriers to the clinical translation of genomic output. Medical oncologists appear to have accepted CGP as an element of clinical care delivery, and feel responsible for discussing the interpretation and management implications with their patients. Understanding their needs is the foundation for establishing appropriate and effective supports and resources. These considerations will be increasingly important with the rapid evolution and integration of genomic-guided clinical management of cancer patients."
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DOI - https://doi.org/10.18632/oncotarget.28076
Full text - https://www.oncotarget.com/article/28076/text/
Correspondence to - Subotheni Thavaneswaran - s.thavaneswaran@garvan.org.au
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
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Oncotarget
Article Title
The experiences and needs of Australian medical oncologists in integrating comprehensive genomic profiling into clinical care: a nation-wide survey