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

Authors: Schram, A. M.; Reales, D.; Galle, J.; Cambria, R.; Durany, R.; Feldman, D.; Sherman, E.; Rosenberg, J.; D'Andrea, G.; Baxi, S.; Janjigian, Y.; Tap, W.; Dickler, M.; Baselga, J.; Taylor, B. S.; Chakravarty, D.; Gao, J.; Schultz, N.; Solit, D. B.; Berger, M. F.; Hyman, D. M.
Article Title: Oncologist use and perception of large panel next-generation tumor sequencing
Abstract: Background: Genomic profiling is increasingly incorporated into oncology research and the clinical care of cancer patients. We sought to determine physician perception and use of enterprise-scale clinical sequencing at our center, including whether testing changed management and the reasoning behind this decision-making. Patients and methods: All physicians who consented patients to MSK-IMPACT, a next-generation hybridization capture assay, in tumor types where molecular profiling is not routinely performed were asked to complete a questionnaire for each patient. Physician determination of genomic 'actionability' was compared to an expertly curated knowledgebase of somatic variants. Reported management decisions were compared to chart review. Results: Responses were received from 146 physicians pertaining to 1932 patients diagnosed with 1 of 49 cancer types. Physicians indicated that sequencing altered management in 21% (331/1593) of patients in need of a treatment change. Among those in whom treatment was not altered, physicians indicated the presence of an actionable alteration in 55% (805/1474), however, only 45% (362/805) of these cases had a genomic variant annotated as actionable by expert curators. Further evaluation of these patients revealed that 66% (291/443) had a variant in a gene associated with biologic but not clinical evidence of actionability or a variant of unknown significance in a gene with at least one known actionable alteration. Of the cases annotated as actionable by experts, physicians identified an actionable alteration in 81% (362/445). In total, 13% (245/1932) of patients were enrolled to a genomically matched trial. Conclusion: Although physician and expert assessment differed, clinicians demonstrate substantial awareness of the genes associated with potential actionability and report using this knowledge to inform management in one in five patients. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
Keywords: targeted therapy; next-generation sequencing; precision medicine; tumor sequencing
Journal Title: Annals of Oncology
Volume: 28
Issue: 9
ISSN: 0923-7534
Publisher: Oxford University Press  
Date Published: 2017-09-01
Start Page: 2298
End Page: 2304
Language: English
DOI: 10.1093/annonc/mdx294
PROVIDER: scopus
PUBMED: 28911072
PMCID: PMC5834089
Notes: Article -- Export Date: 2 November 2017 -- Source: Scopus
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MSK Authors
  1. David Solit
    431 Solit
  2. Maura N Dickler
    237 Dickler
  3. Eric J Sherman
    149 Sherman
  4. Darren Richard Feldman
    171 Feldman
  5. Yelena Yuriy Janjigian
    145 Janjigian
  6. Shrujal S Baxi
    69 Baxi
  7. David Hyman
    181 Hyman
  8. Michael Forman Berger
    380 Berger
  9. William Douglas Tap
    122 Tap
  10. Jianjiong Gao
    62 Gao
  11. Barry Stephen Taylor
    138 Taylor
  12. Nikolaus D Schultz
    196 Schultz
  13. Alison Michele Schram
    21 Schram
  14. Jonathan Eric Rosenberg
    218 Rosenberg
  15. Jose T Baselga
    394 Baselga
  16. Jesse   Galle
    5 Galle
  17. Dalicia Nicole Reales
    5 Reales
  18. Robert Eugene Durany
    3 Durany