Utilization and barriers to genomic profiling in breast cancer treatment among oncologists.

Abstract

e18882 Background: Genomic profiling (GP) may help identify novel, targeted breast cancer (BC) treatments. Increased utilization and technology of GP, including options such as next-generation sequencing (NGS) to identify mutations (e.g., PI3K, PTEN, and AKT) among patients with BC, has allowed for improved care and outcomes. Yet, there are limited standard guidelines for the application of GP, and little is known about current use and challenges in the United States (US). The objective of this study was to describe the utilization of and barriers to GP among US-based community oncologists. Methods: Three live meetings held between July and September 2022 convened oncologists to discuss trends in health care. Participants responded to survey questions online and onsite; not all participants answered every question. Results were aggregated and analyzed using descriptive statistics. Results: A total of 171 physicians participated (primary specialty: 56% hematology/oncology, 42% medical oncology, 2% other). The cohort is geographically diverse (Northeast 23%, Midwest 16%, South 43% and West 18%) and have a median of 18 years of experience. Most participants (92%) are using an NGS-based panel to test their patients with ER+ breast cancer for biomarkers (e.g., PI3K, AKT, and PTEN) and the most common panels utilized are indicated in the table. When treating BC, physicians indicated they most often order NGS-based tests prior to any treatment (33%) or prior to first-line treatment in the relapsed/metastatic setting (47%) (Table). Overall, the top two resources participants felt would increase their use of GP when treating patients with BC are: financial aid and reimbursement support (51%) and more clinical evidence on its utility for improving patient outcomes (48%) (Table). Education on the use of GP and decision support tools were also reported as resources that will increase utilization (34% each). Conclusions: Most oncologists are using GP when managing patients with BC, but the extent of utilization may be limited by barriers. Specifically, a lack of financial aid and/or reimbursement support and evidence on the utility to improve patient outcomes are reported as barriers. Despite high utilization of GP for patients with BC, there remains opportunity to increase uptake, such as more education and access to decision tools, which may increase the utilization and application in oncology settings. [Table: see text]