Use of Next-Generation Sequencing Tests to Guide Cancer Treatment: Results From a Nationally Representative Survey of Oncologists in the United States
Use of Next-Generation Sequencing Tests to Guide Cancer Treatment: Results From a Nationally Representative Survey of Oncologists in the United States
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DOI：
10.1200/po.18.00169
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发表时间：
2018-11-14
影响因子：
4.6
通讯作者：
de Moor, Janet S.
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文献类型：
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作者：
Freedman, Andrew N.;Klabunde, Carrie N.;de Moor, Janet S.
目的 目前尚无关于肿瘤学家在实践中使用下一代测序 (NGS) 检测的全国代表性数据。本研究的目的是调查美国肿瘤学家如何使用 NGS 测试来评估癌症患者并告知治疗建议。 方法 该研究使用了全国癌症治疗精准医学调查的数据，该数据于 2017 年邮寄给全国代表性的肿瘤学家样本（N = 1,281；合作率 = 38%）。计算加权百分比来描述 NGS 测试的使用。进行多变量建模来评估测试使用与肿瘤科医生实践特征之间的关联。结果总体而言，75.6% 的肿瘤科医生报告使用 NGS 测试来指导治疗决策。在这些肿瘤学家中，34.0％的人经常使用它们来指导晚期难治性疾病患者的治疗决策，29.1％的人用来确定临床试验的资格，17.5％的人用来决定食品和药物管理局批准的药物的标签外使用。 NGS 测试结果通常为 26.8% 的肿瘤科医生提供治疗建议，有时为 52.4%，从不或很少为 20.8% 的肿瘤科医生提供治疗建议。年龄低于 50 岁、拥有教职任命、接受过基因组学培训、每月会见超过 50 名独特患者以及能够进入分子肿瘤委员会的肿瘤学家更有可能使用 NGS 测试。 结论 2017 年，美国大多数肿瘤学家都在使用 NGS 测试来指导患者的治疗决策。需要更多的研究来确定这些测试的临床实用性，为其在实践中的使用制定基于证据的临床指南，并确保可以从这些新技术中受益的患者接受适当的测试和治疗。 (C) 2018 年美国临床肿瘤学会
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. (C) 2018 by American Society of Clinical Oncology