Effectively communicating comprehensive tumor genomic profiling results: Mitigating uncertainty for advanced cancer patients

Bartley, Nicci; Best, Megan; Biesecker, Barbara B.; Fisher, Alana; Goldstein, David; Meiser, Bettina; Thomas, David M.; Ballinger, Mandy L.; Butow, Phyllis

doi:10.1016/j.pec.2021.05.018

Cited by 5 publications

(22 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Researchers have suggested that this may be due to the disempowerment of patients regarding confidence to navigate cancer care due to a poor understanding of the process. [7,8]. Similarly, our group reported that advanced cancer patients who received non-actionable CGP results had increased distress and lower satisfaction with their decision to undergo CGP than patients with actionable results [9].…”

Section: Introductionmentioning

confidence: 69%

Return of comprehensive tumour genomic profiling results to advanced cancer patients: a qualitative study

Best

Bartley

Napier

et al. 2022

Support Care Cancer

Self Cite

View full text Add to dashboard Cite

Purpose The introduction of comprehensive tumour genomic profiling (CGP) into clinical oncology allows the identification of molecular therapeutic targets. However, the potential complexity of genomic results and their implications may cause confusion and distress for patients undergoing CGP. We investigated the experience of advanced cancer patients receiving CGP results in a research setting. Methods Semi-structured interviews with 37 advanced cancer patients were conducted within two weeks of patients receiving CGP results. Interviewees were purposively sampled based on CGP result, cancer type, age and gender to ensure diversity. Themes were derived from interview transcripts using a framework analysis approach. Results We identified six themes: (1) hoping against the odds; (2) managing expectations; (3) understanding is cursory; (4) communication of results is cursory; (5) genomics and incurable cancer; and (6) decisions about treatment. Conclusion Despite enthusiasm regarding CGP about the hope it provides for new treatments, participants experienced challenges in understanding results, and acceptance of identified treatments was not automatic. Support is needed for patients undergoing CGP to understand the implications of testing and cope with non-actionable results.

show abstract

Section: Introductionmentioning

confidence: 69%

Return of comprehensive tumour genomic profiling results to advanced cancer patients: a qualitative study

Best

Bartley

Napier

et al. 2022

Support Care Cancer

Self Cite

View full text Add to dashboard Cite

show abstract

“…These results confirm those by Bombard et al (2014), who assessed patient perceptions of gene expression profiling in breast cancer treatment decisions and found that the perceived benefits included the ability to reduce uncertainty. In our previous qualitative study, we found that advanced cancer patients desired immediate, clear and simple information that promotes certainty, thus highlighting that health professionals' communication skills are critical in meeting patient expectations (Bartley et al, 2021).…”

Section: Discussionmentioning

confidence: 90%

Psychological predictors of advanced cancer patients’ preferences for return of results from comprehensive tumor genomic profiling

Meiser

Butow

Davies

et al. 2021

American J of Med Genetics Pt A

Self Cite

View full text Add to dashboard Cite

This study assessed the psychological predictors of preferences for return of comprehensive tumor genomic profiling (CTGP) results in patients with advanced cancers, enrolled in the Molecular Screening and Therapeutics Program. Patients completed a questionnaire prior to undergoing CTGP. Of the 1434 who completed a questionnaire, 96% would like to receive results that can guide treatment for their cancer, and preference for receiving this type of result was associated with lower tolerance of uncertainty. Sixty-four percent would like to receive results that cannot guide treatment, and lower tolerance of uncertainty, self-efficacy, and perceived importance were associated with this preference. Fifty-nine percent would like to receive variants of unknown significance, which was associated with lower tolerance of uncertainty, higher self-efficacy, and perceived importance. Eighty-six percent wanted to receive germline results that could inform family risk. This was associated with higher self-efficacy, perceived importance, and perceived susceptibility. Although most patients wanted to receive all types of results, given the differing patient preferences regarding the return of results depending on the utility of the different types of results, it appears critical to safeguard patient understanding of result utility to achieve informed patient choices. This should be accompanied by appropriate consent processes.

show abstract

“…12,20,33,37,41,43 Also, additional costs and potential insurance issues were challenging for patients interested in undergoing cBT. 19,20,26,35,37 These concerns of potential health and social discrimination were shared by HCPs surveyed in three other studies. 18,45,46 Additionally, the included studies often did not specify the timepoints (e.g., days/weeks after diagnosis, pre-or post-surgery or first-line therapy) and manner (e.g., in-person or via telephone consultation, type of appointment, used language, time spent) in which HCPs communicated with patients regarding cBT.…”

Section: Search Outcomesmentioning

confidence: 92%

Understanding communication between patients and healthcare professionals regarding comprehensive biomarker testing in precision oncology: A scoping review

Pichler,

Mumm,

Dehar

et al. 2024

Cancer Medicine

View full text Add to dashboard Cite

BackgroundPrecision oncology, using comprehensive biomarker testing (cBT) to inform individual cancer diagnosis, prognosis and treatment, includes increasingly complex technology and clinical data sets. People impacted by cancer (patients and caregivers) and healthcare professionals (HCPs) face distinct challenges in navigating the cBT and personalized treatment landscape. This review summarizes evidence regarding cBT‐related communication between people impacted by cancer and HCPs and identifies important avenues for future research in precision oncology.MethodsA scoping review was conducted using records published in PubMed during January 2017–August 2022, focusing on the breadth of topics on patient‐HCP communication and knowledge resources used by HCPs as guidance in cBT‐related communication. Data were extracted from records meeting inclusion criteria, and findings were summarized according to main topics.ResultsThe search identified 287 unique records and data were extracted from 42 records, including nine from expert input. Most records originated from the United States included patients with different types of cancer, and oncologists were the main HCPs. Patients' motivation for undergoing cBT and receiving results was generally high in different settings. However, patients' understanding of cBT‐related concepts was limited, and their knowledge and information preferences changed based on cBT implications and significance to family members. HCPs were valued by patients as a trusted source of information. Limited evidence was available on HCPs' information‐seeking behavior and factors influencing cBT‐related knowledge and confidence, often self‐reported as insufficient.ConclusionsPatient education by knowledgeable and confident HCPs, information management and a caring patient‐HCP relationship communicating continuity of care regardless of cBT results are crucial to empower patients and shared decision‐making in precision oncology. More data on the process and structure of cBT‐related communication, distinction between and characterization of different timepoints of patient‐HCP interactions are needed.

show abstract

Effectively communicating comprehensive tumor genomic profiling results: Mitigating uncertainty for advanced cancer patients

Cited by 5 publications

References 33 publications

Return of comprehensive tumour genomic profiling results to advanced cancer patients: a qualitative study

Return of comprehensive tumour genomic profiling results to advanced cancer patients: a qualitative study

Psychological predictors of advanced cancer patients’ preferences for return of results from comprehensive tumor genomic profiling

Understanding communication between patients and healthcare professionals regarding comprehensive biomarker testing in precision oncology: A scoping review

Contact Info

Product

Resources

About