Poster Presentation COSA 2015 ASM

Oncology patients’ attitudes toward, and experiences with, somatic mutation tumour testing (#260)

Roger Liang 1 , Bettina Meiser 2 , Sian Smith 2 , Nadine Kasparian 3 , Craig Lewis 4 , Melvin Chin 5 , Georgina Long 6 , Robyn Ward 5 , Alex Menzies 6 , Alex Guminski 6 , Julie Harris-Wai 7 , Rajneesh Kaur 2
  1. University of New South Wales, Sydney, NSW, Australia
  2. Psychosocial Research Group, Prince of Wales Clinical School, Sydney, NSW, Australia
  3. Discipline of Paediatrics, School of Women’s and Children’s Health, UNSW Medicine, Kensington, NSW, Australia
  4. Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW, Australia
  5. Prince of Wales Clinical School, Randwick, NSW, Australia
  6. Melanoma Institute Australia and The University of Sydney, Sydney, NSW, Australia
  7. Division of Research, Kaiser Permanente Northern California, Oakland, California, USA

Introduction: Somatic mutations in key oncogenes in lung adenocarcinoma and melanoma are important determinants of tumour sensitivity to genetically targeted therapies. Predictive molecular testing for these somatic mutations is routinely used to guide the effective and efficient use of personalised anticancer treatment. This qualitative study will explore patients’ attitudes and understanding of molecular ‘tumour testing’, their experiences of receiving results from these tests, and their associated information and decision support needs.

Methods: Patients with advanced lung adenocarcinoma or melanoma were invited to participate in a semi-structured face-to-face or telephone interview by their treating oncologist. With the use of a semi-structured interview guide, their experiences and preferences regarding the tumour testing process and receiving results were elicited. Each interview was audiotaped, transcribed and analysed for thematic patterns using the qualitative methodology of pragmatic realism (Miles, Huberman, & Saldana, 2014).

Results: Data collection and analysis is ongoing. We will continue recruitment until redundancy of information is achieved, which we anticipate will occur once a sample size of about 20 participants per cancer group has been achieved. As of August 2015, 16 patients with lung adenocarcinoma and eight with advanced melanoma have completed interviews. Overall, patients hold positive views and expectations of tumour testing, and understand that it is used by their oncologist to guide treatment decisions. They prefer to receive information about tumour testing as soon as possible after diagnosis, but emphasise the importance of clear communication using basic, non-technical language. Commonly reported barriers to understanding include informational overload, complex genomic concepts, and residual psychological distress from their cancer diagnosis.

Conclusions: Although patients generally feel informed and confident with their oncologist’s use of tumour testing to help make treatment decisions, findings indicate that they would benefit from decision-related and educational tools to clearly communicate genomic information and realistic expectations of treatment benefit.

  1. Miles, M. B., Huberman, A. M., & Saldana, J. (2014). Qualitative data analysis: A methods sourcebook (3rd ed.). London: Sage.