1337P Implementation of precision oncology in clinical practice: A nationwide survey in Italy

Abstract

Two main aspects are leading precision oncology implementation into clinical practice: the adoption of extended genome sequencing technologies and the institutions and activity of Molecular Tumor Boards (MTBs). On behalf of CIPOMO (Italian association of Oncology Departments directors) we promoted a national survey to obtain a picture of the adoption of precision medicine into clinical oncology in Italy, considering the provisions of the National Recovery and Resilience Plan. We report the results of the survey. 20 questions were sent via Survey Monkey platform (Individual Advantage version) to 169 heads of medical oncology departments, and their answers were collected from the 10th to 28th of February 2022. 129 directors participated; 113 sets of answers were analyzed. 19 regions out of 21 participated, as a representative sample of the Italian healthcare system. 67.3% of participants are aware of ESMO recommendations on Next-generation sequencing (NGS) use for advanced cancer. NGS is currently used by 52.2% of the Departments at cancer diagnosis; 47.8% base molecular diagnostic on single gene analysis. Among the ones using NGS, 49.2% adopt tumor specific panels, 30.5% a unique pan-tumor panel, 20.3% didn’t answer. 72.3% of respondents find appropriate to limit molecular analysis on biomarkers indicated by scientific guidelines at diagnosis; 27.7% would use a more extended sequencing upfront. MTBs are present in 13 out of Regions but overall 33.6% of Departments has not access to them. Among the Centers with an active MTB, 23.9% routinely refer cases for consultation, 43.7% haven’t done it yet, 32.4% report that the nowadays organization does not fit their needs. NGS technologies and MTBs are not homogeneously implemented in Italy. These results could be a starting point for clinicians, scientific societies and health care institutions to outline the best practices, achieve consensus and formulate recommendations for precision oncology implementation in our current clinical practice.