The use of molecular profiling (MP) beyond standard panels in day-to-day practice: A multi-institutional multinational survey.

Abstract

e17532 Background: The complexity and associated cost of MP in cancer care is rapidly increasing and there are challenges as to its incorporation and utility in day-to-day oncological practice. Methods: A structured survey was sent to 42 institutions in Europe, USA and Asia-Pacific with well-established experience in basic oncology research and drug development. It aimed to gain insight into the frequency of MP beyond standard testing. The results from an 8 week snap-shot period were collated. Results: 42 medical oncologists, 5 radiation oncologists and 4 haematologists from 31 institutions responded; 41 from academic/teaching hospitals, 7 from the private sector and 3 from general hospitals. 26 respondents indicated that MP beyond standard panels was regularly performed. Testing was covered by public funding (38%), grants (35%) or private insurance/self pay (25%) and was performed for the purpose of research, diagnostics and other reasons (48, 47 & 5%, respectively). Gene analyses included DNA/RNA sequencing alone (11%) or in combination with IHC/FISH (38%), gene expression profiling (19%) and/or proteomics (8%). MP analysis was performed on state-of-the-art sequencing platforms (Sanger in 12%, a combination of Sanger and next generation sequencing (NGS) in 35% and NGS alone in 15%). Archived (60%) and fresh frozen biopsies (40%) were analyzed with a turnaround of <1 week (23%), between 1-3 weeks (66%) and >3 weeks (11%). 66% of results were discussed in a multidisciplinary meeting. Biobanking was available in 48% institutions with bioinformatics support available in 29%. The main challenges identified were funding and associated costs, incorporation of bioinformatics, data quality and staying abreast of new technologies. Conclusions: The use of MP beyond standard panels is increasing in both complexity and availability. Mastering clinical accessibility, data volume, and technical innovation will be key to incorporate MP in day–to-day practice.