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Predictors of next-generation sequencing panel selection using a shared decision-making approach.

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Most cancer patients choose broader multi-cancer panels (MCPs) over breast cancer panels (BCPs), with personal cancer history and ethnicity being key predictors. Panel choice did not impact testing outcomes.

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Area of Science:

  • Genetics and Genomics
  • Oncology
  • Clinical Diagnostics

Background:

  • Next-generation sequencing (NGS) panels have advanced cancer genetic testing.
  • Established guidelines for NGS panel selection are currently lacking.
  • A shared decision-making model empowers patients in panel selection.

Purpose of the Study:

  • To identify factors influencing genetic testing panel selection in cancer patients.
  • To report on testing outcomes based on selected panel types.
  • To understand patient preferences for broader gene interrogation.

Main Methods:

  • Demographic and clinical data collected from 265 female breast and/or ovarian cancer patients (≥21 years).
  • Panel types classified as breast cancer panel (BCP) or multi-cancer panel (MCP).
  • Stepwise multiple logistic regression used to determine predictors of panel selection.

Main Results:

  • Majority (81.5%) selected broader multi-cancer panels (MCPs).
  • MCP selection significantly associated with age (≥50), Chinese ethnicity, and personal ovarian cancer history (all p<0.05).
  • Personal cancer history and ethnicity were strongest predictors; family history was not significant.

Conclusions:

  • Most patients prefer comprehensive gene interrogation via MCPs, even with potential uncertainty.
  • Patient demographics and personal cancer history significantly influence panel choice.
  • No significant differences in genetic testing outcomes were observed between BCP and MCP groups.