Evaluating Oncologists' Communication Strategies Regarding Molecular Testing and Immunotherapy

Area of Science:

• Oncology
• Genomics
• Cancer Research

Background:

• Mismatch repair deficiency (dMMR) testing identifies metastatic colorectal cancer (mCRC) patients eligible for immune checkpoint inhibitors (ICIs).
• Effective communication of molecular testing results and ICI therapy is crucial but challenging due to oncologists' varied knowledge and use of jargon, and poor patient comprehension.

Purpose of the Study:

• To characterize how oncologists discuss molecular testing (specifically dMMR) and ICIs with patients.
• To identify effective communication strategies for molecular testing and ICI therapy in mCRC.

Main Methods:

• An observational, qualitative study conducted from 2022-2023.
• Recruited US medical oncologists treating colon cancer for recorded telehealth encounters with standardized patients.
• Utilized NVivo QSR 14 for transcription and content analysis of discussions.

Main Results:

• 21 oncologists participated, discussing dMMR and ICIs with standardized patients.
• Variable terminology was used to describe mismatch repair (MMR), with 'mutation' and 'protein loss' being most common.
• While most oncologists discussed ICIs, few detailed response rates (30%-70%) or severe side effects; germline testing was discussed more than next-generation sequencing.

Conclusions:

• Oncologists exhibit inconsistent communication regarding MMR and ICIs, employing technical jargon and omitting critical information like response likelihood and adverse events.
• A structured communication framework could enhance oncologists' ability to convey essential information about molecular testing and ICIs to patients effectively.