45P Environmental scan of molecular profiling in Canada

Abstract

Colorectal Cancer Canada (CCC) developed a pan-tumour, pan-Canadian survey that was sent to healthcare professionals that aimed to conduct a high-level environmental scan of current molecular profiling practices at cancer care institutions across Canada. The survey was disseminated in August 2020 using the free web-based software Google Forms. Questions were developed by members of CCC in collaboration with a scientific advisory committee. Questions were written to include all cancer types and were optional to answer. Data was collected in Excel format and analyzed using descriptive statistics in November 2020. Data was reported in aggregate only and pooled by province. This research was funded by sponsorships granted to CCC’s Get Personal program. The survey sample consisted of 42 healthcare professionals within 26 different institutions, with at least one representative from each province. According to the survey results, turnaround times (TAT) for predictive biomarkers vary depending on the type of biomarker, testing modality, and the availability of testing in-house, with an average TAT of 3.26 weeks for NGS. 69% of respondents reported that molecular profiling is used to make patient care decisions mostly for patients with metastatic disease, and 59.5% of respondents reported that be done only if there is a Health Canada approved therapy associated with that drug. 86% of respondents reported that medical oncologists are ordering molecular profiling for their patients; however, 80% of respondents suggested pathologists should be the ones ordering molecular profiling for patients. As reported by respondents, the main challenges to molecular profiling included: inadequacy and insufficiency of samples (78%), inadequate reimbursement for the test (66%), unavailability of a certain test (53.7%), and long TATs (48.8%). The lack of standardized guidelines and coordination between centres prevent the administration of precision oncology care in Canada; therefore, in addition to generating knowledge of current profiling practices, this research could potentially influence the health of Canadians on a broader scale, by informing decision-making, influencing standardization of cancer care, and enabling capacity-building in patient-driven research.