Impact of establishing a precision oncology program at a rural academic cancer center on cancer care delivery.

Abstract

e18660 Background: The use of molecular profiling, biomarkers, and other targetable tumor alterations is becoming a central component of modern cancer care. Many oncologists use Next Generation Sequencing to guide treatment decisions. There are many challenges of implementing precision oncology through traditional clinical operations. The purpose of this project is to enhance patient care by establishing a new clinical program with the specific focus of advancing and expanding the utilization of precision oncology. Methods: The precision oncology program (POP) was designed as a consult service and functions to assist oncologists in appropriate testing, interpreting results, and identifying additional treatment options. After referral, the POP committee discusses each patient case and offers testing and/or therapeutic recommendations to the referring provider. POP predominantly focused on patients with unresectable or metastatic solid tumors that had relapsed after at least one line of standard of care therapy. The effect of the program will be measured by the volume of patient consults, the number and nature of recommendations from the consulting program, and the direct impact of recommendations on patient care. Results: There were approximately 323 new diagnoses of advanced stage solid tumors in 2021 at the Ellis Fischel Cancer Center (EFCC) at the University of Missouri-Columbia. There were 205 FoundationOne liquid and tissue Next Generation Sequencing (NGS) of solid tumors ordered since initiation of this service. Utilization of NGS testing has increased by 100% year-over-year from 2020 to 2021 since the implementation of this program. The impact of this program is reflected in the increased NGS testing for multiple malignancy types. Specifically, 34% more NGS tests in advanced lung cancers, 733% in breast, 60% in head and neck cancers, 166% colorectal and 500% in prostate cancer. Since the launch of POP in late 2020, we obtained consults on 46 patients. Additional biomarker testing was recommended for 39% of all consults, with a new actionable target being identified in 33% of patients. The amount of biomarker testing increased from averaging 6-7 tests per month to averaging 21 tests per month with an average number of 5 mutations per sample. Conclusions: The POP consult service has improved the testing and the identification of actionable mutations of patients at EFCC. The program has led to new treatment options in 33% of patients reviewed.