Oncologists Have Mixed Attitudes on the Use of Genomic Testing

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Predictive genomic testing has the potential to usher in an era of personalized cancer care for patients. However, a recent study finds that not all physicians are eager to embrace the technology.

Researchers from Dana-Farber Cancer Institute surveyed 160 physicians from Dana-Farber/Brigham and Women’s Cancer Center, which has a comprehensive research program that allows all consenting patients to have their tumor genome tested for mutations and other DNA changes.

The physicians were asked about their current use of somatic testing (non-inherited mutations in cancers), their attitudes about multiplex testing (a type of test that simultaneously measures multiple substances in a single run/cycle of the test), and their confidence in their ability to understand and use genomic data.

The survey was conducted between 2011 and 2012. Twenty-two percent of physicians reported low confidence in their genomic knowledge. One quarter of physicians (25%) anticipated testing most patients (>90%), while 18% anticipated testing patients infrequently (<10%).

Higher confidence in genomic testing was associated with wanting to test a majority of patients and anticipating using actionable test results or potentially actionable test results to inform treatment recommendations. Just under half (42%) of respondents said they approved disclosing uncertain genomic findings to patients.

Stacy W. Gray, MD, AM, first author of the study and a thoracic cancer physician at Dana-Farber, said:

Some oncologists said we shouldn’t return these results to patients, and others say ‘of course, we should give them to the patient.’ The fact that we found so much variation in physicians’ confidence about their ability to use genetic data at a tertiary care National Cancer Institute–designated comprehensive cancer center makes us pause and wonder about how confident physicians in the community are about dealing with this. It begs the question at the national level, how are we going to make sure that this technology for cancer care is adequately delivered?

The researchers advocate for renewed efforts in physician genomic education and decision support. They conclude that a concerted effort is needed to ensure that physicians present information about predictive multiplex tests to patients in a way that enhances patient understanding and increases patients’ test acceptance.

The study is published in the Journal of Clinical Oncology.

Source: The Asco Post