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dc.contributor.authorvon Itzstein, Mitchell S
dc.contributor.authorSmith, Mary L
dc.contributor.authorRailey, Elda
dc.contributor.authorWhite, Carol B
dc.contributor.authorDieterich, Julianne S
dc.contributor.authorGarrett-Mayer, Liz
dc.contributor.authorBruinooge, Suanna S
dc.contributor.authorFreedman, Andrew N
dc.contributor.authorDe Moor, Janet
dc.contributor.authorGray, Stacy W
dc.contributor.authorPark, Jason Y
dc.contributor.authorYan, Jingsheng
dc.contributor.authorHoang, Anh Quynh
dc.contributor.authorZhu, Hong
dc.contributor.authorGerber, David E
dc.date.accessioned2021-05-25T03:24:58Z
dc.date.available2021-05-25T03:24:58Z
dc.date.issued2021
dc.identifier.issn2688-1527
dc.identifier.doi10.1200/OP.20.00927
dc.identifier.urihttp://hdl.handle.net/10072/404649
dc.description.abstractPURPOSE: Advances in genomic techniques have led to increased use of next-generation sequencing (NGS). We evaluated the extent to which these tests guide treatment decisions. METHODS: We developed and distributed a survey assessing NGS use and outcomes to a survey pool of ASCO members. Comparisons between groups were performed with Wilcoxon two-sample, chi-square, and Fisher's exact tests. RESULTS: Among 178 respondents, 62% were male, 54% White, and 67% affiliated with academic centers. More than half (56%) indicated that NGS provided actionable information to a moderate or great extent. Use was highest (median ≥ 70% of cases) for lung and gastric cancer, and lowest (median < 25% of cases) in head and neck and genitourinary cancers. Approximately one third of respondents reported that, despite identification of an actionable molecular variant, patients were sometimes or often unable to access the relevant US Food and Drug Administration-approved therapy. When NGS did not provide actionable results, individuals reporting great or moderate guidance overall from NGS in treatment recommendations were more likely to request the compassionate use of an unapproved drug (P < .001), enroll on a clinical trial (P < .01), or treat off-label with a drug approved for another indication (P = .02). CONCLUSION: When NGS identifies an actionable result, a substantial proportion of clinicians reported encountering challenges obtaining approved therapies on the basis of these results. Perceived overall impact of NGS appears associated with clinical behavior unrelated to actionable NGS test results, including pursuing off-label or compassionate use of unapproved therapies or referring to a clinical trial.
dc.description.peerreviewedYes
dc.languageeng
dc.publisherAmerican Society of Clinical Oncology (ASCO)
dc.relation.ispartofjournalJCO Oncology Practice
dc.subject.fieldofresearchOncology and carcinogenesis
dc.subject.fieldofresearchcode3211
dc.titleAccessing Targeted Therapies: A Potential Roadblock to Implementing Precision Oncology?
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationvon Itzstein, MS; Smith, ML; Railey, E; White, CB; Dieterich, JS; Garrett-Mayer, L; Bruinooge, SS; Freedman, AN; De Moor, J; Gray, SW; Park, JY; Yan, J; Hoang, AQ; Zhu, H; Gerber, DE, Accessing Targeted Therapies: A Potential Roadblock to Implementing Precision Oncology?, JCO Oncology Practice, 2021
dc.date.updated2021-05-24T01:18:25Z
dc.description.versionVersion of Record (VoR)
gro.description.notepublicThis publication has been entered in Griffith Research Online as an advanced online version.
gro.rights.copyright© 2021 American Society of Clinical Oncology. The attached file is reproduced here in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.
gro.hasfulltextFull Text
gro.griffith.authorVon Itzstein, Mitchell S.


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