Abstract 1559P
Background
Advancement of comprehensive genomic profiling (CGP) technology enables genomic medicine to emerge as a promising cancer treatment selection approach. As clinical implementation expands, concerns arise regarding equity of access and clinical utility. This study investigated the influence of ethnicity, socioeconomic status, and other factors on access to genomic testing at a trials unit in the UK. The clinical impact was also studied.
Methods
A retrospective review of patients referred for CGP between 2015 to 2024 was conducted. The impact of access by age, cancer types, ethnicity, and socioeconomic status defined by Index of Multiple Deprivation (IMD,1 - most deprived; 10 - least deprived) was assessed by comparing against population data from the UK Office for National Statistics. Clinical utility metrics including matching rates to targeted therapies, frequency of genomic aberrations, sequencing success rate, turnaround time were assessed based on medical records.
Results
Data from 406 patients was compared against the catchment area population. Patients from more deprived socioeconomic backgrounds were less likely to partake in CGP (p < 0.001). Black and mixed ethnic background were under-represented in the analysis population (p < 0.001). Clinical utility aligned with larger studies but only 31 (8.2%) patients were started on a matched targeted therapy. Table: 1559P
Summary of demographic characteristics
Age [years, median (range)] | 59 (24-85) |
External referral, n (%) | 120 (29.6%) |
Female, n (%) | 219 (53.9%) |
Ethnicity, n (%) | |
White | 236 (58.1%) |
Non-white | 73 (18.0%) |
Not recorded | 97 (23.9%) |
Socioeconomic status (IMD), n (%) | |
1-2 | 51 (12.7%) |
3-4 | 98 (24.4%) |
5-6 | 98 (24.4%) |
7-8 | 82 (20.4%) |
9-10 | 72 (18.0%) |
No results | 5 |
Cancer types, n (%) | |
Breast | 37 (9.1%) |
Endocrine | 9 (2.2%) |
Gynaecological | 66 (16.3%) |
Head and Neck | 7 (1.7%) |
Hepatobiliary and Pancreatic | 58 (14.3%) |
Upper GI | 21 (5.2%) |
Lower GI | 132 (32.5%) |
Skin | 4 (1.0%) |
Thoracic | 34 (8.4%) |
Urological | 33 (8.1%) |
Unknown Primary | 5 (1.2%) |
Median prior therapy lines, n | 3 |
Conclusions
Matching rate to targeted therapy or clinical trials remained low. The most common barriers were the lack of actionable mutation, unavailability of trials, and poor performance status. We also identified disparities of access to molecular testing associated with socioeconomic status and ethnicity. Current patient recruitment primarily relies on elective referrals from treating clinicians which could be a factor contributing to the observed disparity. Future efforts should focus on establishing a centralised, automated referral pathway.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Guy's and St Thomas' NHS Foundation Trust.
Funding
Has not received any funding.
Disclosure
J. Spicer: Financial Interests, Institutional, Advisory Board, Compensation to my employer for time providing advice: AstraZeneca, BMS, GSK, RS Oncology; Financial Interests, Personal, Stocks/Shares, Co-founder: Epsilogen; Financial Interests, Personal, Stocks/Shares: Avacta; Financial Interests, Institutional, Local PI, Reimbursement for treatment of patients in trial: Achilles, Roche, Trizell, BergenBio, MSD, Gilead, Iovance; Financial Interests, Institutional, Coordinating PI, Reimbursement for treatment of patients in trial: Starpharma, BMS, IO Biotech, RS Oncology; Non-Financial Interests, Leadership Role, National strategy board: Experimental Cancer Medicine Centres; Non-Financial Interests, Member of Board of Directors, Steering Committee: British Thoracic Oncology Group; Non-Financial Interests, Advisory Role, Advice on licensing decisions for MHRA: CHM Expert Advisory Group on Oncology & Haematology; Non-Financial Interests, Advisory Role, Advice on regulatory approvals: CHM Cancer Vaccines Expert Working Group. D. Sarker: Financial Interests, Personal, Advisory Board: Eisai, Ipsen, Bayer, Surface Oncology, AAA, AbbVie, Boehringer Ingelheim, AstraZeneca, Incyte; Financial Interests, Personal, Invited Speaker: MSD, Bayer, AstraZeneca, Eisai, Servier, Incyte; Financial Interests, Personal, Other, Travel and conference fees: Ipsen; Financial Interests, Personal, Other, Travel and Conference Fees: MiNA Therapeutics; Financial Interests, Institutional, Coordinating PI: UCB, MiNA Therapeutics; Financial Interests, Institutional, Local PI: Eisai, Medivir AB, MSD, Bayer, RedX, GSK, Starpharma, Adaptimmune, Blueprint, H3, Regeneron, Taiho, AstraZeneca, Ipsen; Financial Interests, Institutional, Funding: Roche, Inspirata; Non-Financial Interests, Advisory Role: Medivir, UCB, MiNA Therapeutics. All other authors have declared no conflicts of interest.
Resources from the same session
1481P - A case-control study of drug-eluting microspheres and blank microspheres in bronchial artery embolization for hemoptysis in non-small cell lung cancer
Presenter: Tongguo Si
Session: Poster session 10
1482P - Percutaneous transhepatic biliary drainage (PTBD) for palliation of jaundice in patients of unresectable/disseminated carcinoma gall bladder with hilar block: Is it a worthwhile enterprise?
Presenter: Saurabh Galodha
Session: Poster session 10
1484P - Inflammatory patterns of ascites in patients with solid tumors
Presenter: Julia Berger
Session: Poster session 10
1485P - Mitigating symptom clusters of patients with metastatic cancer through a remote physical exercise program (EXIO)
Presenter: Paulo Bergerot
Session: Poster session 10
1486P - A personalized rehabilitation pilot program for improving QOL of unresectable metastatic lung cancer patients
Presenter: Shani Shilo
Session: Poster session 10
1487P - Telemonitoring system effectiveness for alleviating cancer pain in patients with advanced cancer
Presenter: Shiori Yoshida
Session: Poster session 10
1488P - Use of mobile app “SUPPORT+” to enhance community palliative care in advanced cancer patients: A feasibility study
Presenter: Wendy Chan
Session: Poster session 10
1489P - Factors influencing adherence to electronic patient-reported outcomes in palliative cancer care
Presenter: Sarah Gomes
Session: Poster session 10
1490P - Health-related quality of life of cancer patients on chemotherapy and its relationship with caregiver strain: A cross-sectional analytical study
Presenter: Herald Mapa
Session: Poster session 10
Resources:
Abstract