Use of Next-Generation Sequencing Tests to Guide Cancer Treatment: Results From a Nationally Representative Survey of Oncologists in the United States

Andrew N Freedman; Carrie N Klabunde; Kristine Wiant; Lindsey Enewold; Stacy W Gray; Kelly K Filipski; Nancy L Keating; Debra G B Leonard; Tracy Lively; Timothy S McNeel; Lori Minasian; Arnold L Potosky; Donna R Rivera; Richard L Schilsky; Deborah Schrag; Naoko I Simonds; Helmneh M Sineshaw; Jeffery P Struewing; Gordon Willis; Janet S de Moor

doi:10.1200/PO.18.00169

Use of Next-Generation Sequencing Tests to Guide Cancer Treatment: Results From a Nationally Representative Survey of Oncologists in the United States

JCO Precis Oncol. 2018 Nov 13:2:PO.18.00169. doi: 10.1200/PO.18.00169. eCollection 2018 Nov.

Authors

Andrew N Freedman¹, Carrie N Klabunde¹, Kristine Wiant¹, Lindsey Enewold¹, Stacy W Gray¹, Kelly K Filipski¹, Nancy L Keating¹, Debra G B Leonard¹, Tracy Lively¹, Timothy S McNeel¹, Lori Minasian¹, Arnold L Potosky¹, Donna R Rivera¹, Richard L Schilsky¹, Deborah Schrag¹, Naoko I Simonds¹, Helmneh M Sineshaw¹, Jeffery P Struewing¹, Gordon Willis¹, Janet S de Moor¹

Affiliation

¹ , , , , , , , and , National Cancer Institute; , Information Management Services, Rockville; , National Institutes of Health; , National Human Genome Research Institute, Bethesda; , Scientific Consulting Group, Gaithersburg, MD; , RTI International, Research Triangle Park, NC; , City of Hope, Duarte, CA; , Harvard Medical School and Brigham and Women's Hospital; , Dana-Farber Cancer Institute, Boston, MA; , University of Vermont Health Network and the University of Vermont, Burlington, VT; , Georgetown University, Washington, DC; , American Society of Clinical Oncology, Alexandria, VA; and , American Cancer Society, Atlanta, GA.

Abstract

Purpose: There are no nationally representative data on oncologists' use of next-generation sequencing (NGS) testing in practice. The purpose of this study was to investigate how oncologists in the United States use NGS tests to evaluate patients with cancer and to inform treatment recommendations.

Methods: The study used data from the National Survey of Precision Medicine in Cancer Treatment, which was mailed to a nationally representative sample of oncologists in 2017 (N = 1,281; cooperation rate = 38%). Weighted percentages were calculated to describe NGS test use. Multivariable modeling was conducted to assess the association of test use with oncologist practice characteristics.

Results: Overall, 75.6% of oncologists reported using NGS tests to guide treatment decisions. Of these oncologists, 34.0% used them often to guide treatment decisions for patients with advanced refractory disease, 29.1% to determine eligibility for clinical trials, and 17.5% to decide on off-label use of Food and Drug Administration-approved drugs. NGS test results informed treatment recommendations often for 26.8%, sometimes for 52.4%, and never or rarely for 20.8% of oncologists. Oncologists younger than 50 years of age, holding a faculty appointment, having genomics training, seeing more than 50 unique patients per month, and having access to a molecular tumor board were more likely to use NGS tests.

Conclusion: In 2017, most oncologists in the United States were using NGS tests to guide treatment decisions for their patients. More research is needed to establish the clinical usefulness of these tests, to develop evidence-based clinical guidelines for their use in practice, and to ensure that patients who can benefit from these new technologies receive appropriate testing and treatment.

Abstract

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