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. 2023 Jun 2;28(6):e324-e330.
doi: 10.1093/oncolo/oyad020.

Implementation of Precision Oncology in Clinical Practice: Results of a National Survey for Health Care Professionals

Gianpiero Fasola  1   2 , Maria C Barducci  1 , Giacomo Pelizzari  1 , Francesco Grossi  3 , Carmine Pinto  4 , Bruno Daniele  2   5 , Monica Giordano  2   6 , Cinzia Ortega  2   7 , Rosa Rita Silva  2   8 , Valeria D Tozzi  9 , Luigi Cavanna  2   10 , Giuseppe Aprile  2   11
Affiliations

Implementation of Precision Oncology in Clinical Practice: Results of a National Survey for Health Care Professionals

Gianpiero Fasola et al. Oncologist. .

Abstract

Background: Two main aspects lead the implementation of precision oncology into clinical practice: the adoption of extended genome sequencing technologies and the institution of the Molecular Tumor Boards (MTBs). CIPOMO (Italian Association of Heads of Oncology Department) promoted a national survey across top health care professionals to gain an understanding of the current state of precision oncology in Italy.

Methods: Nineteen questions were sent via the SurveyMonkey platform to 169 heads of oncology departments. Their answers were collected in February 2022.

Results: Overall, 129 directors participated; 113 sets of answers were analyzed. Nineteen regions out of 21 participated as a representative sample of the Italian health care system. The use of next-generation sequencing (NGS) is unevenly distributed; informed consent and clinical reports are managed differently, as the integration of medical, biologic, and informatics domains in a patient-centered workflow is inconsistent. A heterogeneous MTB environment emerged. A total of 33.6% of the responding professionals did not have access to MTBs while 76% of those who have did not refer cases.

Conclusions: NGS technologies and MTBs are not homogeneously implemented in Italy. This fact potentially jeopardizes equal access chances to innovative therapies for patients. This survey was carried out as part of an organizational research project, pursuing a bottom-up approach to identify the needs and possible solutions to optimize the process. These results could be a starting point for clinicians, scientific societies, and health care institutions to outline the best practices and offer shared recommendations for precision oncology implementation in current clinical practice.

Keywords: healthcare delivery; healthcare innovation implementation; healthcare management research; molecular tumor boards; national survey; precision oncology implementation.

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Conflict of interest statement

Gianpiero Fasola reported honoraria for lectures from AstraZeneca and support for attending meetings from Bristol-Myers Squibb, Merck Sharp & Dohme, Ipsen, and Roche; Giacomo Pelizzari C/A MSD, Boehringer Ingelheim, Astra Zeneca; Other (support for attending meetings) Eli-Lilly (participation on data safety monitoring board), Amgen; reported consulting fees from MSD, Boehringer Ingelheim, and AstraZeneca; support for attending meetings from Eli Lilly; and participation on data safety monitoring board for Amgen; Bruno Daniele reported honoraria for lectures from Eisai, Ipsen, Lilly, Bayer, MSD, Roche, Amgen, Merck Serono, and AstraZeneca; support for attending meetings from AstraZeneca, Sanofi, Celgene, and BMS; and participation on a Data Safety Monitoring Board for Sanofi; Cinzia Ortega reported honoraria for lectures from Janssen and Pfizer; support for attending meetings from Janssen and Pfizer; and participation on data safety monitoring boards for MSD, Pfizer, BMS, and Astellas. Giuseppe Aprile reported consulting fees from Astellas, Amgen, and Incyte; and payment or honoraria for lectures from Astellas, Amgen, AstraZeneca, BMS, Eli-Lilly, Italfarmaco, Novartis, and Seagen. The other authors indicated no financial relationships.

Figures

Figure 1.
Figure 1.
State of the art of molecular diagnostic strategies and use of next-generation sequencing (NGS) panels. (a) Current molecular diagnostic strategy; (b) type of NGS panels used; (c) pantumor panels’ extension; and (d) responders’ opinion on the most appropriate diagnostic strategy.
Figure 2.
Figure 2.
State of the art of Molecular Tumor Boards (MTBs) implementation. (a) Presence of MTB in the Italian territory; (b) MTB institution levels in different regions; (c) current cases’ referral; and (d) opinion on the most appropriate level for MTB institution.
Figure 3.
Figure 3.
Oncology directors’ opinion on Molecular Tumor Board (MTB) activity and composition (a) current and expected cases referral to MTB; and (b) opinion on the professional composition of MTB.
See this image and copyright information in PMC

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