Title

A randomized study of genetic education versus usual care in tumor profiling for advanced cancer in the ECOG-ACRIN Cancer Research Group (EAQ152)

Authors

Angela R. Bradbury, University of Pennsylvania/Abramson Cancer Center, Philadelphia, Pennsylvania.
Ju-Whei Lee, ECOG-ACRIN Biostatistics Center, Dana-Farber Cancer Institute, Boston, Massachusetts.
Jill Bennett Gaieski, University of Pennsylvania/Abramson Cancer Center, Philadelphia, Pennsylvania.
Shuli Li, ECOG-ACRIN Biostatistics Center, Dana-Farber Cancer Institute, Boston, Massachusetts.
Ilana F. Gareen, ECOG-ACRIN Biostatistics Center, Brown University, Providence, Rhode Island.
Keith T. Flaherty, Massachusetts General Hospital Cancer Center, Boston, Massachusetts.
Benjamin A. Herman, ECOG-ACRIN Biostatistics Center, Brown University, Providence, Rhode Island.
Susan M. Domchek, University of Pennsylvania/Abramson Cancer Center, Philadelphia, Pennsylvania.
Angela M. DeMichele, University of Pennsylvania/Abramson Cancer Center, Philadelphia, Pennsylvania.
Kara N. Maxwell, University of Pennsylvania/Abramson Cancer Center, Philadelphia, Pennsylvania.
Adedayo A. Onitilo, Weston Center, Marshfield Clinic, Marshfield, Wisconsin.
Shamsuddin Virani, Advocate Aurora HealthFollow
SuJung Park, Medical Oncology Hematology Consultants PA, Newark, Delaware.
Bryan A. Faller, Missouri Baptist Medical Center, Saint Louis, Missouri.
Stefan C. Grant, Wake Forest University Health Sciences, Winston-Salem, North Carolina.
Ryan C. Ramaekers, CHI Health Saint Francis, Grand Island, Nebraska.
Robert J. Behrens, Medical Oncology and Hematology Associates, Des Moines, Iowa.
Gopakumar S. Nambudiri, Saint John's Hospital-Healtheast, Maplewood, Minnesota.
Ruth C. Carlos, University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan.
Lynne I. Wagner, Wake Forest University Health Sciences, Winston-Salem, North Carolina.

Affiliations

Aurora Cancer Care-Southern Lakes VLCC

Abstract

Background: Enthusiasm for precision oncology may obscure the psychosocial and ethical considerations associated with the implementation of tumor genetic sequencing.

Methods: Patients with advanced cancer undergoing tumor-only genetic sequencing in the National Cancer Institute Molecular Analysis for Therapy Choice (MATCH) trial were randomized to a web-based genetic education intervention or usual care. The primary outcomes were knowledge, anxiety, depression, and cancer-specific distress collected at baseline (T0), posteducation (T1) and after results (T2). Two-sided, 2-sample t tests and univariate and multivariable generalized linear models were used.

Results: Five hundred ninety-four patients (80% from NCI Community Oncology Research Program sites) were randomized to the web intervention (n = 293) or usual care (n = 301) before the receipt of results. Patients in the intervention arm had greater increases in knowledge (P for T1-T0 < .0001; P for T2-T0 = .003), but there were no significant differences in distress outcomes. In unadjusted moderator analyses, there was a decrease in cancer-specific distress among women (T0-T1) in the intervention arm but not among men. Patients with lower health literacy in the intervention arm had greater increases in cancer-specific distress and less decline in general anxiety (T0-T1) and greater increases in depression (T0-T2) in comparison with those receiving usual care.

Conclusions: Web-based genetic education before tumor-only sequencing results increases patient understanding and reduces distress in women. Refinements to the intervention could benefit low-literacy groups and men.

Document Type

Article

PubMed ID

34890045

Link to Full Text

 

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