Targeted and immune-cancer therapy options are increasingly available among oncologists and patients in Asia. Devising the most appropriate personalized treatment for each and every cancer patient has become possible thanks to the introduction of multiplexed next-generation sequencing (NGS) technology – comprehensive genomic profiling (CGP). However, the adopting CGP in the clinical setting remains much laggard even in the most advanced Asian countries. This study compares and contrasts how CGP is perceived and practiced in patients with cancer in Singapore and Taiwan.
A group of 30 community-based medical oncologists in Singapore and Taiwan were surveyed to gain their insight and perception of using (or not using) NGS-based CGP as a diagnostic toolkit in their clinical decision making. The survey questions are categorized into four dimensions: clinical utility, value for money, literacy of tests, and socio-cultural issues.
Most (65%) of participants consider the use of CGP can provide clinical insight and value in advanced stages of cancer. Around two fifths of community oncologists expressed concern that CGP rarely provides clinically actionable, evidence-based information, especially for cancers that either lack robust clinical evidence on genomic pathways or without access to clinical trials. One third attributed the slow uptake of CGP to the uncertain value for money. One fifth opined there are often insufficient samples available for genomic testing, and one third complained of the long turnaround time in getting the results frustrated. Taiwanese participants are more acceptable in deciphering lengthy reports through interactive communication than their Singaporean counterpart, whereas the latter expresses that socio-cultural issues, such as reimbursement and insurance exclusivity, are not as significant in patients.
In Asia, due to its heterogeneity and diversity in socio-economic and cultural aspects, the clinical utility of deploying CGP remains unclear given the paucity of loco-regional data and evidence. This paper points out the barriers of CGP adoption in Asia.
Clinical trial identification
Legal entity responsible for the study
A. Lai: The author\'s work is related to NGS.