Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Feb 21:2:PO.17.00122.
doi: 10.1200/PO.17.00122. eCollection 2018.

Oncologists' Use of Genomic Sequencing Data to Inform Clinical Management

Michele C Gornick  1 , Erin Cobain  1 , Lan Q Le  1 , Natalie Bartnik  1 , Elena Stoffel  1 , Scott Schuetze  1 , Moshe Talpaz  1 , Arul Chinnaiyan  1 , J Scott Roberts  1 ; Michigan Oncology Sequencing Study
Affiliations

Oncologists' Use of Genomic Sequencing Data to Inform Clinical Management

Michele C Gornick et al. JCO Precis Oncol. .

Abstract

Purpose: To determine whether oncologists intended to change treatment as a result of tumor sequencing, and subsequently, whether patients experienced an alteration of clinical management or derived clinical benefit.

Patients and methods: A prospective survey of oncologists referring adult patients with rare, advanced, or refractory cancer to the Michigan Oncology Sequencing program was conducted from June 2014 to March 2015 to assess the use of and intent to disclose sequencing findings. Oncologists' responses were compared with the referred patients' self-reported survey responses, and a content analysis of disclosure documented in the medical record was performed. Medical records were reviewed retrospectively to determine if clinical management was informed or changed by sequencing results.

Results: Oncologists (response rate, 93%) referring 112 consecutive patients were surveyed. Medical records of patients were reviewed for changes in clinical management on the basis of sequencing findings. Oncologists intended to change the treatment of 22% of patients (n = 24) on the basis of sequencing findings. Of these patients, 37.5% (n = 9) had an actual change in clinical management. Thirty-four patients with postsequencing survey data reported that a results disclosure discussion did not occur, despite documentation of disclosure by the physician in the medical record.

Conclusions: Findings demonstrate that many oncologists view next-generation sequencing results to be potentially valuable in directing subsequent therapy for their patients; however, barriers in communicating results to patients and implementing them in clinical management remain.

PubMed Disclaimer

Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/po/author-center. Michele C. GornickNo relationship to discloseErin CobainConsulting or Advisory Role: AstraZenecaLan Q. LeNo relationship to discloseNatalie BartnikNo relationship to discloseElena StoffelResearch Funding: Cancer Prevention Pharmaceuticals (Inst)Scott SchuetzeConsulting or Advisory Role: EMD Serono, Janssen Pharmaceuticals, Daiichi Sankyo Research Funding: AB Science (Inst), Janssen Pharmaceuticals (Inst), Amgen (Inst), BioMed Valley Discoveries (Inst), CytRx (Inst), Plexxikon (Inst), Eli Lilly (Inst), Karyopharm Therapeutics (Inst), Adaptimmune (Inst)Moshe TalpazConsulting or Advisory Role: Gilead Sciences, CTI BioPharma, Nynex Research Funding: Gilead Sciences, Incyte, CTI BioPharma, ARIAD Pharmaceuticals, Novartis, Aptose Biosciences, Pfizer, Sanofi Expert Testimony: Bristol-Myers Squibb CanadaArul ChinnaiyanConsulting or Advisory Role: TempusJ. Scott RobertsNo relationship to disclose

Figures

Fig 1.
Fig 1.
Study flowchart. MI-ONCOSEQ, Michigan Oncology Sequencing program; RR, response rate.
See this image and copyright information in PMC

References

    1. Collins FS, Varmus H. A new initiative on precision medicine. N Engl J Med. 2015;372:793–795. - PMC - PubMed
    1. Garraway LA. Genomics-driven oncology: Framework for an emerging paradigm. J Clin Oncol. 2013;31:1806–1814. - PubMed
    1. National Cancer Institute: NCI-MATCH Trial (Molecular Analysis for Therapy Choice (NCI-MATCH). https://www.cancer.gov/about-cancer/treatment/clinical-trials/nci-suppor....
    1. American Society of Clinical Oncology: Targeted Agent and Profiling Utilization Registry (TAPUR) study. http://www.tapur.org/ - PubMed
    1. Tsimberidou AM, Wen S, Hong DS, et al. Personalized medicine for patients with advanced cancer in the phase I program at MD Anderson: Validation and landmark analyses. Clin Cancer Res. 2014;20:4827–4836. - PMC - PubMed