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General Medical Sciences
Results of a survey suggest that some physicians aren’t ready to embrace multiplex genomic testing in cancer patients, while others plan to offer the testing to most of their patients.
The variation in attitudes is, in part, associated with physician confidence.
Physicians who reported having a lot of confidence in their ability to use and explain genomic findings were more likely to want to prescribe tests and consider using test results when making treatment recommendations.
But physicians with lower levels of confidence were more reluctant to offer such testing.
Researchers were surprised by these findings because the survey was carried out at the Dana-Farber/Brigham and Women’s Cancer Center, which has a research program that allows all consenting patients to undergo tests to reveal mutations and other DNA changes that drive their cancer.
The team was perplexed by another finding as well. Forty-two percent of responding oncologists approved of telling patients about test results even when their significance for the patient’s outlook and treatment is uncertain.
This issue comes with the growing use of multiplex testing, which can hunt for tens or hundreds of mutant genes simultaneously and often detects rare DNA variants that may or may not be relevant to an individual’s cancer.
“Some oncologists said we shouldn’t return these results to the patient, and others say, ‘Of course, we should give them to the patient,’” said study author Stacy W. Gray, MD, of the Dana-Farber Cancer Institute in Boston.
“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 a national level: how are we going to make sure that this technology for cancer care is adequately delivered?”
The survey was conducted in 2011 and early 2012 as a baseline assessment of physicians’ attitudes prior to the rollout of a tumor profiling project called Profile. The Profile technology platform includes complete DNA sequencing of more than 300 genomic regions to detect known and unknown cancer-related mutations.
The technology can also examine those regions for gains and losses of DNA sequences and rearrangements of DNA on chromosomes. The results are entered into a database for research purposes, but, if patients agree, the clinically important findings can also be returned to their doctor for use in the clinic.
A total of 160 cancer physicians—including medical oncologists, surgeons, and radiation oncologists—participated in the survey.
They were asked about their current use of somatic testing, their attitudes about multiplex testing, and their confidence in their ability to understand and use genomic data. The survey did not include a direct test of the physicians’ knowledge.
Respondents said they ordered tumor genomic testing on an average of 24% of patients. Twenty-two percent of the doctors reported low confidence in their knowledge about genomics.
Fourteen percent lacked knowledge in explaining these concepts to patients, and 26% doubted their ability to make treatment recommendations based on genomic data. Perhaps for these reasons, 18% of the physicians said they planned to use multiplex tumor testing infrequently.
Dr Gray and her colleagues concluded that there is “little consensus” on how physicians plan to use this technology for personalized cancer care and suggested the need for evidence-based guidelines to help doctors determine when testing is indicated.
The researchers reported their findings in the Journal of Clinical Oncology. A related editorial is available in the journal as well. 
General Medical Sciences
Results of a survey suggest that some physicians aren’t ready to embrace multiplex genomic testing in cancer patients, while others plan to offer the testing to most of their patients.
The variation in attitudes is, in part, associated with physician confidence.
Physicians who reported having a lot of confidence in their ability to use and explain genomic findings were more likely to want to prescribe tests and consider using test results when making treatment recommendations.
But physicians with lower levels of confidence were more reluctant to offer such testing.
Researchers were surprised by these findings because the survey was carried out at the Dana-Farber/Brigham and Women’s Cancer Center, which has a research program that allows all consenting patients to undergo tests to reveal mutations and other DNA changes that drive their cancer.
The team was perplexed by another finding as well. Forty-two percent of responding oncologists approved of telling patients about test results even when their significance for the patient’s outlook and treatment is uncertain.
This issue comes with the growing use of multiplex testing, which can hunt for tens or hundreds of mutant genes simultaneously and often detects rare DNA variants that may or may not be relevant to an individual’s cancer.
“Some oncologists said we shouldn’t return these results to the patient, and others say, ‘Of course, we should give them to the patient,’” said study author Stacy W. Gray, MD, of the Dana-Farber Cancer Institute in Boston.
“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 a national level: how are we going to make sure that this technology for cancer care is adequately delivered?”
The survey was conducted in 2011 and early 2012 as a baseline assessment of physicians’ attitudes prior to the rollout of a tumor profiling project called Profile. The Profile technology platform includes complete DNA sequencing of more than 300 genomic regions to detect known and unknown cancer-related mutations.
The technology can also examine those regions for gains and losses of DNA sequences and rearrangements of DNA on chromosomes. The results are entered into a database for research purposes, but, if patients agree, the clinically important findings can also be returned to their doctor for use in the clinic.
A total of 160 cancer physicians—including medical oncologists, surgeons, and radiation oncologists—participated in the survey.
They were asked about their current use of somatic testing, their attitudes about multiplex testing, and their confidence in their ability to understand and use genomic data. The survey did not include a direct test of the physicians’ knowledge.
Respondents said they ordered tumor genomic testing on an average of 24% of patients. Twenty-two percent of the doctors reported low confidence in their knowledge about genomics.
Fourteen percent lacked knowledge in explaining these concepts to patients, and 26% doubted their ability to make treatment recommendations based on genomic data. Perhaps for these reasons, 18% of the physicians said they planned to use multiplex tumor testing infrequently.
Dr Gray and her colleagues concluded that there is “little consensus” on how physicians plan to use this technology for personalized cancer care and suggested the need for evidence-based guidelines to help doctors determine when testing is indicated.
The researchers reported their findings in the Journal of Clinical Oncology. A related editorial is available in the journal as well.
General Medical Sciences
Results of a survey suggest that some physicians aren’t ready to embrace multiplex genomic testing in cancer patients, while others plan to offer the testing to most of their patients.
The variation in attitudes is, in part, associated with physician confidence.
Physicians who reported having a lot of confidence in their ability to use and explain genomic findings were more likely to want to prescribe tests and consider using test results when making treatment recommendations.
But physicians with lower levels of confidence were more reluctant to offer such testing.
Researchers were surprised by these findings because the survey was carried out at the Dana-Farber/Brigham and Women’s Cancer Center, which has a research program that allows all consenting patients to undergo tests to reveal mutations and other DNA changes that drive their cancer.
The team was perplexed by another finding as well. Forty-two percent of responding oncologists approved of telling patients about test results even when their significance for the patient’s outlook and treatment is uncertain.
This issue comes with the growing use of multiplex testing, which can hunt for tens or hundreds of mutant genes simultaneously and often detects rare DNA variants that may or may not be relevant to an individual’s cancer.
“Some oncologists said we shouldn’t return these results to the patient, and others say, ‘Of course, we should give them to the patient,’” said study author Stacy W. Gray, MD, of the Dana-Farber Cancer Institute in Boston.
“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 a national level: how are we going to make sure that this technology for cancer care is adequately delivered?”
The survey was conducted in 2011 and early 2012 as a baseline assessment of physicians’ attitudes prior to the rollout of a tumor profiling project called Profile. The Profile technology platform includes complete DNA sequencing of more than 300 genomic regions to detect known and unknown cancer-related mutations.
The technology can also examine those regions for gains and losses of DNA sequences and rearrangements of DNA on chromosomes. The results are entered into a database for research purposes, but, if patients agree, the clinically important findings can also be returned to their doctor for use in the clinic.
A total of 160 cancer physicians—including medical oncologists, surgeons, and radiation oncologists—participated in the survey.
They were asked about their current use of somatic testing, their attitudes about multiplex testing, and their confidence in their ability to understand and use genomic data. The survey did not include a direct test of the physicians’ knowledge.
Respondents said they ordered tumor genomic testing on an average of 24% of patients. Twenty-two percent of the doctors reported low confidence in their knowledge about genomics.
Fourteen percent lacked knowledge in explaining these concepts to patients, and 26% doubted their ability to make treatment recommendations based on genomic data. Perhaps for these reasons, 18% of the physicians said they planned to use multiplex tumor testing infrequently.
Dr Gray and her colleagues concluded that there is “little consensus” on how physicians plan to use this technology for personalized cancer care and suggested the need for evidence-based guidelines to help doctors determine when testing is indicated.
The researchers reported their findings in the Journal of Clinical Oncology. A related editorial is available in the journal as well.