Oncologist use and perception of large panel next-generation tumor sequencing

Area of Science:

• Oncology
• Genomics
• Clinical Research

Background:

• Genomic profiling is integral to modern oncology research and patient care.
• Physician adoption and impact of large-scale clinical sequencing require evaluation.
• Understanding management decisions based on genomic data is crucial.

Purpose of the Study:

• To assess physician perception and utilization of enterprise-scale clinical sequencing.
• To determine if genomic testing changed patient management and the rationale behind decisions.
• To compare physician assessment of genomic 'actionability' with expert curation.

Main Methods:

• Physicians completed questionnaires for patients consented to MSK-IMPACT sequencing.
• Genomic 'actionability' assessments by physicians were compared to a curated knowledgebase.
• Reported management decisions underwent chart review for verification.

Main Results:

• Physicians reported altered management in 21% of 1932 patients across 49 cancer types.
• Discrepancies noted between physician and expert assessments of genomic variant actionability.
• 13% of patients were enrolled in a genomically matched clinical trial.

Conclusions:

• Clinicians show significant awareness of actionable genes in cancer.
• Physician-reported use of genomic data informs management in approximately one in five patients.
• Differences in actionability assessment highlight areas for improved genomic interpretation and integration into clinical practice.