158P - Enhancing the communication of genomic results: Understanding patient and clinician perspectives

Background

Patients (pts) participating in early phase cancer clinical trials (EPCCTs) often have access to genomic testing (GT). There remains significant variation in how GT results are communicated to pts and healthcare providers (HCP), with limited evidence on pts’ preferences.

Methods

A mixed-methods approach was utilised to explore the feedback of GT results. A questionnaire was developed and distributed to 60 clinicians involved with EPCCTs, to understand processes followed when informing pts of GT results. Clinicians were also presented with nine statements related to barriers to feedback and asked to rate on a 5-point Likert scale. Opinions regarding pt/carer experiences with GT were examined through focus groups recruited through a single cancer centre, wherein attendees reviewed a generic GT report and clinician feedback letter and provided feedback.

Results

Data from 37 clinicians across 10 UK sites were collated (response rate: 62%). The majority (92%) ensured pts received feedback on their GT results. Face-to-face methods were used by 38% of all respondents whilst 16% used letters; 14% phone calls; and 32% used a combination of methods. 57% of clinicians would feedback on all GT results, while 30% would only report on actionable mutations. Furthermore, 59% of clinicians expressed an interest in receiving training on how to feedback GT results to pts, with 35% of clinicians indicating they were not confident in understanding the GT information. Four patient/carer focus groups involving 24 participants (18 pts with a current/previous cancer diagnosis; four family members and two carers) with varying experiences of GT revealed two main themes. The information provided must be easily understandable to pts. A tailored summary of the main genomic findings would be preferred, and pts would like to be directed to regulated and reliable information about GT, recommended by their HCPs. A preference for face-to-face consultations when receiving GT results.

Conclusions

It is important to consider pt preference and the feasibility for clinicians when developing feedback mechanisms for return of GT results. Increased educational opportunities around the interpretation of GT are required for pts/carers and HCPs.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

The authors.

Funding

Manchester Academic Health Science Centre (MAHSC).

Disclosure

M.G. Krebs: Financial Interests, Personal, Advisory Board: Bayer, Roche, Janssen, Guardant Health; Financial Interests, Personal, Invited Speaker: Roche, Janssen; Financial Interests, Institutional, Expert Testimony: AstraZeneca; Financial Interests, Institutional, Advisory Board: Seattle Genetics; Financial Interests, Institutional, Invited Speaker: AstraZeneca, Blueprint, Astex, Bayer, BerGenBio, Carrick, Immutep, Janssen, Novartis, Nurix, Nuvalent, Pyramid Biosciences, Roche, Seattle Genetics, Turning Point Therapeutics; Financial Interests, Institutional, Research Grant: Roche, Novartis; Other, Personal, Other, Travel expenses for congress: Immutep, Janssen.D.M. Graham: Financial Interests, Personal, Advisory Board, Consulting role on advisory board: Clinigen; Financial Interests, Personal, Invited Speaker: Cancer Drug Development Fund; Financial Interests, Personal, Advisory Board: McCann Health; Financial Interests, Institutional, Invited Speaker, Institutional funding from study: MSD, Codiak Biosciences, Starpharma, Faron Pharmaceuticals, Synthon, Janssen; Financial Interests, Institutional, Other, Sub-I: Institutional funding from study: AstraZeneca, Roche, BerGenBio, GSK, Bayer, Bicycle Pharmaceuticals, Carrick, Taiho Pharmaceuticals, CytomX Therapeutics, RedX Pharma PLC, Eisai Inc., Octimet, Orion Pharma, Kinex Pharmaceuticals, Boehringer Ingelheim, BMS, Turning Point Therapeutics, Immutep, Agalimmune, Kymab, Blueprint, Astellas, Cellcentric, UCB Biopharma USL, Eli Lilly, Seagen, Repare Therapeutics, Timepoint Therapeutics, Astex, Stemline, Crescendo Biologics Ltd., ADC Therapeutics, Genentech, Avacta Life Sciences Ltd., Nurix Therapeutics Inc., Chugai Pharmaceuticals; Financial Interests, Institutional, Invited Speaker: Incyte; Financial Interests, Institutional, Research Grant: AstraZeneca. F. Thistlethwaite: Financial Interests, Personal, Advisory Board, Ad board: BMS; Financial Interests, Personal, Advisory Board, Ad boards: GSK; Financial Interests, Personal, Advisory Board, Adboard/consultancy: T-Knife Therapeutics; Financial Interests, Personal, Advisory Board: Adicet, Janssen, EnaraBio, Immatics, Ixaka, Scenic Biotech, F-Star, Leucid; Financial Interests, Institutional, Advisory Board: Pfizer; Financial Interests, Personal, Invited Speaker: Kite Gilead; Financial Interests, Personal, Other, Occasional individual consulting: Guidepoint; Financial Interests, Institutional, Other, iMATCH is a 12 partner consortium funded by not for profit Innovate UK (UK government body) partners include commercial, clinical and academic institutes. I am director and my salary (0.1WTE) is supported through this work as a grant to my institution (The Christie NHS foundation trust - not for profit NHS hospital) from IUK: iMATCH director; Financial Interests, Institutional, Officer, Clinical lead for this 10 partner consortium of clinical academic and commercial partners. My salary is partly supported (approx. 0.05WTE) through this by a grant paid by Innovate UK (a NFP government body) to my institution (The Christie NHS foundation trust a NFP UK hospital): SAMPLE; Financial Interests, Institutional, Invited Speaker, NCT02890069: Novartis; Financial Interests, Institutional, Research Grant, Sarcoma pathways project: GSK; Financial Interests, Institutional, Invited Speaker, NCT02493751: Pfizer; Financial Interests, Institutional, Invited Speaker, NCT03245736, NCT02988817, NCT02552121, NCT02001623: GenMab; Financial Interests, Institutional, Invited Speaker, NCT02277717: Synthon; Financial Interests, Institutional, Invited Speaker, NCT03013491: CytomX; Financial Interests, Institutional, Invited Speaker, NCT03314935: Incyte; Financial Interests, Institutional, Invited Speaker, NCT02908906: Janssen; Financial Interests, Institutional, Invited Speaker, NCT03132792, NCT04044768,: Adaptimmune; Financial Interests, Institutional, Invited Speaker, NCT03400332: BMS; Financial Interests, Institutional, Invited Speaker, NCT04262466, NCT03973333, NCT03515551: Immunocore; Financial Interests, Institutional, Invited Speaker, EudraCT Number: 2018-001005-85, 2018-003446-16: Achilles ltd; Financial Interests, Institutional, Invited Speaker: Agalimmune Ltd.; Financial Interests, Institutional, Invited Speaker, NCT02834247: Millennium Pharmaceuticals/Takeda; Financial Interests, Institutional, Invited Speaker, NCT02690350: Daiichi Sankyo; Financial Interests, Institutional, Invited Speaker, NCT04839991: Crescendo; Financial Interests, Institutional, Invited Speaker, NCT05104515: Oxford Vacmedix Ltd.; Financial Interests, Institutional, Invited Speaker, NCT05278975: RS Oncology LLC; Financial Interests, Institutional, Invited Speaker, NCT03697824, NCT03391778: GSK; Financial Interests, Institutional, Invited Speaker, NCT04140500, NCT04857138, NCT04826003: Roche; Financial Interests, Institutional, Invited Speaker, NCT04272203: AbbVie; Financial Interests, Personal, Invited Speaker, NCT05008913, NCT04949425, NCT0331509, NCT03313557: AstraZeneca; Financial Interests, Institutional, Invited Speaker, NCT03829501: Kymab Ltd./Sanofi; Financial Interests, Institutional, Invited Speaker, EUDRACT ID No: 2019-003329-11: Chugai; Financial Interests, Institutional, Invited Speaker, NCT05430555: T-Knife Therapeutics; Financial Interests, Institutional, Invited Speaker, NCT03621982: ADCT Therapeutics; Financial Interests, Institutional, Research Grant, IRAS Project ID: 227414: Novartis; Non-Financial Interests, Personal, Other, Panel member for a funding committee (MRC is a UK government NFP organisation): MRC DPFS panel member; Non-Financial Interests, Personal, Advisory Role, Sarcoma UK is a not-for-profit charity. I act as an advisor on their Research Strategy Committee. This role is not compensated: Sarcoma UK; Non-Financial Interests, Personal, Leadership Role, Funding is from not-for-profit government bodies. Role is not compensated: Chair of the Independent Steering Committee for NIHR Blood & Transplant Research Unit, Oxford; Non-Financial Interests, Personal, Advisory Role, Funding panel member for CRUK (not-for profit charity). Role is not compensated: CRUK New Agents Committee Member; Non-Financial Interests, Personal, Leadership Role, Chair of Cell therapy subgroup. MRC is a not-for-profit organisation. Role is not compensated: MRC Advanced Therapies Task Group. L. Carter: Financial Interests, Personal, Other, Consultancy: Bicycle Therapeutics, Boehringer Ingelheim, Athenex; Financial Interests, Personal, Full or part-time Employment, Medical Advisor: Cancer Research UK Centre for Drug Development; Financial Interests, Institutional, Invited Speaker: Boehringer Ingelheim, Bicycle Therapeutics, Cellcentric, Eli Lilly, Athenex, Lupin Limited, Repare Therapeutics, Cytomx therapeutics, EMD Serono/Merck KGaA, Sierra Oncology. N. Cook: Financial Interests, Institutional, Invited Speaker: Roche, Taiho, AstraZeneca, RedX, Orion, Avacta, Bayer, Eisai, UCB, Starpharma, Boehringer Ingelheim, Stemline, Ergomed, LOXO Oncology, Nutide; Non-Financial Interests, Personal, Advisory Role: Roche. All other authors have declared no conflicts of interest.