Use, attitudes, and perceptions of tumor genomic testing: Survey of TAPUR physicians.

person Suanna S. Bruinooge American Society of Clinical Oncology, Alexandria, VA info_outline Suanna S. Bruinooge, Amylou C. Dueck, Stacy W. Gray, Nicole L. Butler, Carol B. White, Mary Lou Smith, Pam K. Mangat, Allison W. Kurian, Elda Railey, Sarah T. Hawley, Richard L. Schilsky

Authors person Suanna S. Bruinooge American Society of Clinical Oncology, Alexandria, VA info_outline Suanna S. Bruinooge, Amylou C. Dueck, Stacy W. Gray, Nicole L. Butler, Carol B. White, Mary Lou Smith, Pam K. Mangat, Allison W. Kurian, Elda Railey, Sarah T. Hawley, Richard L. Schilsky Organizations American Society of Clinical Oncology, Alexandria, VA, Mayo Clinic, Scottsdale, AZ, City of Hope, Duarte, CA, Carol B. White & Associates, Evanston, IL, Research Advocacy Network, Naperville, IL, Stanford School of Medicine, Stanford, CA, Research Advocacy Network, Plano, TX, University of Michigan, Ann Arbor, MI Abstract Disclosures Research Funding Other Background: This survey of Targeted Agent and Profiling Utilization Registry (TAPUR) Study physicians examined use, attitudes, and perception of tumor genomic testing (TGT), defined as any DNA test performed on tumor specimen/plasma. TAPUR is a multibasket study of marketed agents targeting tumor genomics. Methods: 333 physicians at 54 TAPUR sites were surveyed (2016-2017). Survey domains included use of TGT, barriers to ordering TGT, and genomic confidence. Surveys included 3 scenarios for TGT ordering 1) pretreated advanced cancer patients (pts) without options, 2) newly diagnosed, untreated, metastatic pts and 3) early stage/potentially curable pts with standard options. Data were analyzed with descriptive statistics. Results: 112 physicians responded (33%). The table displays demographics and genomic confidence. Respondents reported a median of 25% of their pts had TGT in past 12 months for trials/routine care (range 0-85%). Barriers to testing included access to tumor specimen (86%), insurance coverage (67%), concerns that results will not be actionable (55%), and test issues (wait time, unsure which test/lab to use, test accuracy) (54%). TGT was ordered most often for scenario 1 (96%) and 2 pts (70%). Few respondents (32%) would order testing in scenario 3. Of those who reported testing for scenarios 1 & 2, most told pts that results could inform treatment/prognosis/trials (97%) or may be uninformative (84%). In all scenarios, pt expectations of TGT results were discussed prior to testing. A minority reported frequently telling pts in advance that results could inform heritable cancer susceptibility (37%). Conclusions: Confidence in using TGT was high. TGT was performed most for pts with advanced cancer and few options. Availability of specimens was largest barrier reported, indicating the importance of blood-based tests. Few respondents discussed implications of germline findings in advance, despite growing evidence of germline findings in somatic testing. Male 70% Hem/Oncs 89% >15 yrs after med school 66% Somewhat/very confident TGT knowledge 98% Somewhat/very confident ability to recommend treatment from TGT results 95% Somewhat/very confident ability to explain TGT results to pts 99%