Guide

132 oncologists participated in a survey and each published their own knowledge of genome testing. These experts are both optimistic and concerned about the use of genomic detection in tumors. Although oncologists may have contradictions about the utility of genomic testing, they all have a unified belief that tumor molecular research will become more common in the coming years.

Genomic testing is a powerful tool for tumor precision medicine. A survey found that most oncologists believe that genomic testing has made important advances in cancer research. However, many people believe that genomic testing is currently over-promoted because the application of technical value is still lower than expected.

Let's take a look at this survey. The survey was led by Medscape, a well-known professional medical website in the United States, and Jack West, director of the Thoracic Oncology Program of the Swedish Cancer Institute. A total of 132 oncologists participated in the survey from December 2016 to February 2017. How oncologists use a new generation of sequencers to evaluate the entire tumor genome, especially to understand the clinical oncologist's understanding of genomic testing.

Genomic detection in tumors, optimism is uneasy

West said that many people are optimistic about the use of genomic detection in the treatment of malignant tumors, but most of this stems from the promotion of genomic testing by cancer precision medical companies.

Oncologists and oncologists face the challenge of deciphering genome reports. The survey found that about one-third of doctors worry that genomic testing can provide less clinically available information, 18% of doctors say that there are usually not enough tissue samples for genomic testing, and 17% of doctors say cost-effectiveness comparison of tumor gene testing Low, some doctors believe that tumor genome detection takes a long time to get results.

For patient benefit, 60% of physicians said that less than 25% of patients benefited from genomic testing, and one in three doctors said that genomic testing could help 25% to 50% of patients. In addition, three-quarters of doctors said that genomic testing results in the recruitment of clinical volunteers, but the number of patients voluntarily joining clinical trials does not exceed 25%.

Other studies have also shown that the number of cancer patients who eventually receive clinical trials or receive personalized medicine is not too much. Many of the people surveyed believe that multiple somatic genetic testing has not yet had clear clinical value, and expressed concern about the excessive use of the test, as well as concerns about the effectiveness of clinical trials in commercial companies.

Promoting tumor genome testing requires more guidance

Most oncologists believe that more education is needed before genome recognition is widely advocated. The survey found that only 30% of people were instructed during genome testing. West said that many oncologists are generally confused and cautious about how to use test results and how to interpret test results, especially when encountering unusual mutations.

Although oncologists have some silent attitudes toward NGS testing, 90% of them have scheduled genomic testing in the past 5 months, and nearly a quarter have scheduled genomic testing in the past week. They have two reasons for genomic testing: guiding treatment decisions (66%) and guiding clinical trials (16%). The survey found that when standard treatment options do not work, oncologists turn to genomic testing.

Most oncologists say they have no confidence in using test results to guide treatment decisions and counseling patients. There are no specific guidelines for the diversity of multi-gene panels, and there are no clear guidelines for patient-specific conditions, so 44% of oncologists say they refer to the National Comprehensive Cancer Network guidelines, and 32% say they Will turn to scientific research.

The payment problem of genome detection needs to be clear

Payment for genome testing is another area of ​​uncertainty. Three-quarters of the oncologists surveyed said that patients would not use the money in their pockets for genome testing, and 78% of oncologists believe that insurance companies should extend coverage to all tests with viable evidence.

Currently, there are a variety of payment methods for genomic testing. Most tests (85%) are paid for by the patient's private health insurance, 35% of the tests are paid by the research fund, and 29% of the tests are paid for by the patient.

In this survey, the majority of respondents indicated that the insurance coverage of genomic testing is not clearly defined, which hinders the patient's acceptance of it. In addition, the unapproved test will hinder the results in personalized medicine. application.

Conclusion

Although oncologists surveyed have concerns about genomic testing, most oncologists believe that genomic testing is useful. West said that although oncologists may have contradictions about the utility of genomic testing, they all have a unified belief that tumor molecular research will become more common in the next few years.

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