Abstract 1788P
Background
Despite the increased utilization of NGS, there are ongoing barriers to use. The purpose of this study was to identify barriers to NGS use from the physician’s perspective and preferred strategies to address these challenges and optimize the clinical management of cancer.
Methods
A cross-sectional online survey, including both closed- and open-ended questions, was sent to a nationally representative sample of oncologists, surgeons, and pathologists (N=201). The survey collected data on barriers to NGS testing, and potential strategies for improving its translation to clinical care.
Results
Although 99.5% of physicians reported using NGS, 80.1% also reported barriers associated with its use, including reimbursement challenges, lack of knowledge about NGS, and limited evidence of clinical utility. All proposed strategies for addressing these barriers were rated as useful by over 60% of physicians surveyed, but relative importance of each tactic differed by specialty. Surgeons prioritized improving communication within multidisciplinary healthcare teams (88.0%), and pathologists prioritized increased educational content (84.4%), while oncologists prioritized increasing testing coverage (84.0%). Additional lower-priority suggestions for improving NGS use included hiring experts with relevant skills, increasing patient education, and updating technology. Table: 1788P
Strategies for improving NGS bse by physician specialty, %
| Total N=201 | Oncology N=100 | Pathology N=51 | Surgery N=50 | |
| Increased NGS coverage | 83.6 | 84.0 | 84.3 | 82.0 |
| Increased clinical utility evidence | 79.7 | 82.0 | 74.5 | 80.0 |
| Standardized testing & reporting guidelines | 78.6 | 73.0 | 82.4 | 86.0 |
| NGS educational content | 76.6 | 69.0 | 84.4 | 84.0 |
| Bioinformatics support | 75.2 | 66.0 | 84.3 | 84.0 |
| Establishment of minimally acceptable technical standards | 74.7 | 72.0 | 84.3 | 70.0 |
| Improved multi-disciplinary communication | 74.2 | 70.0 | 68.6 | 88.0 |
Conclusions
The results highlight the different roles specialists play in patient management. Additionally, multiple strategies were identified for addressing each barrier, indicating the importance of the multidisciplinary clinical pathway in oncology care. Given the varied needs of different specialties, engaging physicians in development of multi-pronged programs to address testing barriers is of utmost importance.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Merck & Co., Inc.
Funding
Merck & Co., Inc.
Disclosure
A. Kaminski: Financial Interests, Personal, Full or part-time Employment, null: OPEN Health; Financial Interests, Institutional, Other, Paid consultant: Merck & Co., Inc. E. Szamreta: Financial Interests, Personal, Full or part-time Employment: Merck & Co., Inc.; Financial Interests, Personal, Stocks/Shares: Merck & Co., Inc. R. Shah: Financial Interests, Personal, Full or part-time Employment: OPEN Health; Financial Interests, Institutional, Other, Paid Consultant: Merck & Co., Inc. N. Ning: Financial Interests, Personal, Full or part-time Employment: OPEN Health; Financial Interests, Institutional, Other, Paid Consultant: Merck & Co., Inc. J. Aggarwal: Financial Interests, Institutional, Other, Paid Consultant: Merck & Co., Inc.; Financial Interests, Personal, Stocks/Shares: OPEN Health; Financial Interests, Personal, Full or part-time Employment: Open Health. G. Adeboyeje: Financial Interests, Personal, Full or part-time Employment: Merck & Co., Inc.; Financial Interests, Personal, Stocks/Shares: Merck & Co., Inc. A. Hussain: Financial Interests, Personal, Advisory Board: Aveo; Financial Interests, Personal, Other, Consultant: Bayer; Financial Interests, Personal, Other, Consultant: Merck & Co., Inc.; Non-Financial Interests, Institutional, Principal Investigator, Phase 3 Trial of ADT, abiraterone +/- capivasertib in mCSPC with PTEN loss (CAPItello): AstraZeneca; Non-Financial Interests, Institutional, Principal Investigator, Phase 3 Trial of docetaxel +/- nivolumab in patients with mCRPC: Bristol Myers Squibb; Non-Financial Interests, Institutional, Principal Investigator, Phase 2 Trial of Everolimus +/- Teglenostat in mRCC (ENTRATA trial): Calithera; Non-Financial Interests, Institutional, Principal Investigator, Phase 3 Trial of cabozantinib +/- teglenostat in mRCC (CANTATA): Calithera; Non-Financial Interests, Institutional, Principal Investigator, Phase 3 Trial of Rucaparib vs. SOC: Clovis; Non-Financial Interests, Institutional, Principal Investigator, Phase 2 Trial of Rucaparib in mCRPC with HRR defects post chemotherapy (Triton 2): Clovis; Non-Financial Interests, Institutional, Principal Investigator, Phase 2 study of enzalutamide +/- EZH2 inhibitor in mCRPC: Constellation; Non-Financial Interests, Institutional, Principal Investigator, Randomized Phase 2 trial of radium 223 +/- olaparib in mCRPC: ETCTN (NCI); Non-Financial Interests, Institutional, Principal Investigator, Phase 1 trial of histone acetyltransferase inhibitor in mCRPC: Forma ; Non-Financial Interests, Institutional, Principal Investigator, Phase 3 Trial of Pegylated IL2 + Nivolumab vs. SOC in mRCC: Nektar; Non-Financial Interests, Institutional, Principal Investigator, Phase 2 trial of enzalutamide +/- 131-I-PSMA in mCRPC: Progenics; Non-Financial Interests, Institutional, Principal Investigator, Phase 1/2 Trial of FAP-IL2 + Atezolizumab +/- Bevacizumab: Roche ; Non-Financial Interests, Institutional, Principal Investigator, Phase 3 trial of docetaxel +/- radium 223 in mCRPC: Sloan-Kettering Memorial Cancer Center; Non-Financial Interests, Institutional, Principal Investigator, Phase 3 trial of docetaxel +/- dendritic cell based vaccine in mCRPC: Sotio.