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Impact of a Clinical Genomics Program on Trial Accrual for Targeted Treatments: Practical Approach Overcoming

Carol J Farhangfar1, Gregory T Scarola1,2, Victoria A Morris3

  • 1Department of Translational Research, Levine Cancer Institute, Atrium Health, Charlotte, NC.

JCO Clinical Cancer Informatics
|July 15, 2022
PubMed
Abstract

Insights

Implementing an integrated clinical genomics program (CGP) with a virtual Molecular Tumor Board (MTB) significantly increased molecular profiling (MP) use and clinical trial enrollment, benefiting diverse patient populations.

Area of Science:

  • Oncology
  • Genomics
  • Clinical Trials

Background:

  • Precision oncology relies on molecular profiling (MP) for targeted therapies, but its broad adoption faces challenges.
  • Integrated clinical genomics programs (CGP) with decision support can overcome these hurdles.

Purpose of the Study:

  • To evaluate the impact of an integrated CGP, including a virtual Molecular Tumor Board (MTB), on MP utilization and clinical trial accrual.
  • To assess the program's effectiveness across different practice settings and physician experiences, particularly for isolated clinicians.

Main Methods:

  • A longitudinal study (2010-2020) assessed MP and MTB use across practice locations and physician experience levels.
  • Clinical trial enrollment rates were compared between patients with MP alone versus those with both MP and MTB review.
  • Treatment recommendation adherence and reasons for non-adherence were analyzed.

Main Results:

  • MP use and the number of physicians utilizing it increased over tenfold post-CGP implementation.
  • Clinical trial accrual rose from 15% (MP alone) to 28% (MP and MTB review).
  • Proportions of Hispanic and African American patients tested showed minimal disparities compared to the overall system population.

Conclusions:

  • Integrated CGP with decision support, trial matching, and cost management enhances MP use across all physician experience levels.
  • This approach improves clinical trial accrual and has the potential to reduce disparities in molecular profiling.
  • Addressing factors like trial availability and patient costs is crucial for widespread MP adoption.

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