1080O_PR - Physicians' awareness and understanding of personalized medicine in the treatment of cancer and its adoption in clinical practice: a multinational...

Date 28 September 2014
Event ESMO 2014
Session Issues facing oncologists today
Topics Bioethics, Legal, and Economic Issues
Presenter Fortunato Ciardiello
Citation Annals of Oncology (2014) 25 (5): 1-41. 10.1093/annonc/mdu438
Authors F. Ciardiello1, J. Tabernero2, T. Seufferlein3, J. Taieb4, V. Moiseyenko5, B. Ma6, G. Lopez7, R. Esser8, R. Adams9
  • 1Division Of Medical Oncology, Department Of Experimental And Clinical Medicine And Surgery "f. Magrassi And A. Lanzara",, Second University of Naples, 80131 - Naples/IT
  • 2Medical Oncology, Vall d’Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona/ES
  • 3Zentrum Für Innere Medizin, Klinik Für Innere Medizin I, Universitätsklinikum Ulm, Ulm/DE
  • 4Hepatogastroenterology Department, European Hospital Georges Pompidou, Paris/FR
  • 5Medical Oncology, Clinical Center of Specialized Medical Care (Oncological), St Petersburg/RU
  • 6Department Of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories/HK
  • 7Oncology And Palliative Care Services, Hospital Prof. Dr. Bernardo A Houssay, Buenos Aires/AR
  • 8Medical Director, Merck KGaA, Darmstadt/DE
  • 9Department Of Clinical Oncology, Velindre Hospital Cancer Centre and University of Cardiff, Cardiff/GB

Abstract

Aim

The use of biomarkers to identify patients (pts) more likely to benefit from specific targeted therapies is well documented. A survey of oncology physicians was undertaken to monitor the awareness and use of biomarkers in clinical practice.

Methods

Between 28 October and 6 December 2013, 10-minute online interviews were conducted with physicians from 12 representative countries in Europe, South America and Asia. All were practicing oncology specialists, with 3–35 years' experience, treating >15 pts a month.

Results

Interviews were completed by 895 physicians, 50% of whom had identified metastatic colorectal cancer as their highest patient caseload, with 25% recording stage IV breast cancer and 25% stage IIIb/IV NSCLC. According to the survey, the majority of physicians globally (90%) are currently using biomarker testing, the most commonly used tests being for KRAS mutation (87%) and hormone receptor (84%) status and HER2 expression (80%). Of the minority not currently performing biomarker testing, 55% of physicians identified cost or lack of reimbursement as key issues. Most physicians (82%) believed that treatment decision is a process shared between the doctor and/or the multidisciplinary team and the pt, although there are evident regional differences. Yet <23% of physicians believed their pts were always fully informed. Physicians felt that nurses were the best source of information for their pts, but only 45% think their pts had access to nurse support. 82% of physicians thought their pts would delay treatment for additional tumor testing and 85% of physicians said their pts would be willing to have a re-biopsy, if there was a chance they could receive a drug that might work better for them. Although globally 73% of physicians believed their pts were aware that tumors can be tested to help them decide which treatment to give, this fell to 55% in Germany and Turkey.

Conclusions

Physicians globally are aware of the value of biomarker testing and the importance of personalized medicines but do not necessarily feel that their pts are currently well informed enough about their options to fully participate in treatment decisions.

Survey initiated and funded by Merck Serono.

Disclosure

F. Ciardiello: Advisory boards: Roche, Merck Serono, AstraZeneca, Astellas, Bayer, Lilly Research funding: Bayer, AstraZeneca, Merck Serono; J. Tabernero: Consultant/Advisory Board: Amgen, Imclone, Lilly, Merck KGaA, Millennium, Novartis, Roche, Sanofi, Celgene, Chugai and Taiho Compensation: Compensated Honoraria from presentations: Amgen, Merck KGaA, Novartis, Roche and Sanofi Relationship: Myself; T. Seufferlein: Lecture fees from Merck-Serono; J. Taïeb: Advisory role and speaker for Merck, Roche, Amgen, Bayer, Sanofi; V. Moiseyenko: I am the director of the Clinical Center of the specialized medical care (oncological) in St. Petersburg (Russia); B. Ma: Merck Serono (Hong Kong): research funding. Novartis: research funding Sanofi: Research funding, honorarium as speaker; R. Esser: Salaried employee at Merck KGaA Stock ownership of Merck KGaA; R. Adams: I have received travel expenses and consultancy fees from Merck Serono, Roche and Sanofi. All other authors have declared no conflicts of interest.