Patient perspectives on molecular tumor profiling: "Why wouldn't you?"

Area of Science:

• Genomic Medicine
• Oncology
• Cancer Research

Background:

• Advanced cancer patients often exhaust conventional therapies.
• Genomic testing, including molecular tumor profiling (MTP), offers potential for novel treatment identification.
• Understanding patient attitudes towards MTP is crucial for research program integration.

Purpose of the Study:

• To explore patient attitudes towards molecular tumor profiling (MTP) and result return.
• To assess patient perspectives before undergoing genomic testing in a research setting.
• To identify key motivators and concerns regarding MTP in advanced cancer.

Main Methods:

• Purposive sampling of 20 advanced/metastatic solid cancer patients offered MTP.
• Semi-structured interviews conducted around the time of consent for MTP.
• Thematic analysis of interview transcripts, cross-validated with survey responses (n=569).

Main Results:

• All interviewed participants consented to MTP without reservation.
• Key themes: desire for novel treatments, altruism, trust in oncologists/science despite poor genomic understanding, and survival as the primary priority.
• Identification of germline variants was considered secondary to receiving life-prolonging treatment.

Conclusions:

• Advanced cancer diagnosis appeared to mitigate concerns regarding MTP.
• Patient engagement in research was driven primarily by the pursuit of survival and treatment.
• While positive attitudes towards MTP were observed, limited patient understanding of genomics was evident.