A randomized study of genetic education versus usual care in tumor profiling for advanced cancer in the ECOG‐ACRIN Cancer Research Group (EAQ152). Issue 7 (10th December 2021)

• Record Type: Journal Article
• Authors: Bradbury, Angela R.; Lee, Ju‐Whei; Gaieski, Jill Bennett; Li, Shuli; Gareen, Ilana F.; Flaherty, Keith T.; Herman, Benjamin A.; Domchek, Susan M.; DeMichele, Angela M.; Maxwell, Kara N.; Onitilo, Adedayo A.; Virani, Shamsuddin; Park, SuJung; Faller, Bryan A.; Grant, Stefan C.; Ramaekers, Ryan C.; Behrens, Robert J.; Nambudiri, Gopakumar S.; Carlos, Ruth C.; Wagner, Lynne I.
• Is Part Of: Cancer. Volume 128:Issue 7(2022)
• Page Start: 1381
• Page End: 1391
• Publication Date: 2021-12-10
• Subjects: genetic education -- online education intervention -- precision oncology -- tumor sequencing; Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.34063
• Languages: English
• ISSNs: 0008-543X

Abstract

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. Abstract : In the Communication and Education in Tumor Profiling (COMET) study, patients with advanced cancer undergoing tumor genetic sequencing in the National Cancer Institute Molecular Analysis for Therapy Choice (MATCH) trial have been randomized to a web‐based genetic education intervention or usual care. Web‐based genetic education has resulted in increased patient understanding and reduced distress in female patients with cancer.