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A. Ciupek
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P1.01 - Advanced NSCLC (ID 757)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.01-036 - Identifying and Addressing Gaps in Molecular Testing for Patients with Lung Cancer (ID 9391)
09:30 - 16:00 | Author(s): A. Ciupek
- Abstract
Background:
For metastatic non-small cell lung cancer (NSCLC), guidelines include molecular testing for actionable biomarkers and recommend broad profile testing. Yet previous studies indicate that not all patients with NSCLC are receiving testing, even for actionable mutations in EGFR, ALK, and ROS. We hypothesized that rates of molecular testing would be low for patients calling a community HelpLine and that we could potentially increase testing rates with one-on-one caller education and providing free precision medicine services.
Method:
Caller statistics were collected on the toll-free Lung Cancer Alliance (LCA) HelpLine from Sept 1, 2016 – May 31, 2017. Recruitment to the LungMATCH molecular testing program began Nov 10, 2017. Patients are recruited through conversations on the LCA HelpLine, then entered into Perthera Cancer Analysis (PCA) through consent into an IRB-approved registry protocol. PCA includes tissue acquisition, multi-omic molecular profiling, and medical review of testing results and clinical and treatment history. PCA reports are returned to both treating physicians and patients. Data is being collected longitudinally on treatment decisions, patient outcomes including progression-free and overall survival, and patient experience.
Result:
Data from the LCA Helpline identified a gap in molecular testing. 44% (100/228) of patients who were asked if they received any kind of molecular testing replied "No". Of 46 patients who were tested and knew the results, patients indicated changes in EGFR (25), PD-L1 (10), ALK (5), KRAS (4), MET(2), BRAF, and RET. Most of these alterations are potentially actionable. From Nov 10, 2016 – May 31, 2016, 63 interested patients were referred for PCA. Sixteen patients consented and eight more are currently in the consent process. Reasons for non-consent include: doctor refusal, initiation of testing at the treating institution, concern about financial implications, and seven deaths. Ten patients are actively undergoing PCA and six have received completed PCA reports. Of those six, three patients reported that treatment decisions were made using the molecular testing information. Updated results will be presented.
Conclusion:
Caller data indicate that patients with lung cancer are not receiving molecular testing in accordance to guidelines. To address this problem, we introduced a program through a nonprofit-corporate partnership that navigates patients and their physicians through a comprehensive precision therapy program. This type of program is feasible and there is patient interest.
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P1.11 - Patient Advocacy (ID 697)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Patient Advocacy
- Presentations: 1
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.11-003 - A Personalized Navigation Program to Increase Clinical Trial Participation of Lung Cancer Patients (ID 8219)
09:30 - 16:00 | Author(s): A. Ciupek
- Abstract
Background:
Only three to five percent of newly diagnosed cancer patients participate in clinical trials (Lara PN, 2001). We previously conducted a survey of U.S. lung cancer patients and found only 22% reported discussing clinical trial participation with their oncologist at the time of making treatment decisions (Fenton L, 2009). We hypothesized that a personalized navigation program could increase the amount of lung cancer patients initiating trial conversations with their oncologists and ultimately trial participation. Here we describe initial results from a pilot program, offering personalized, telephone-based clinical trial support to lung cancer patients.
Method:
Callers to Lung Cancer Alliance's 1-800 support line between 8/1/2016 and 6/7/2017 were asked if they had considered clinical trial participation and willing callers were referred to a clinical trial navigator for further discussion about clinical trial options. Navigators provided basic clinical trial education and a personalized list of clinical trial matches based on discussion. Patients were encouraged to discuss these trials with their treating oncologist. Navigators then regularly followed up with participants, via email or phone, at two to four week intervals, to offer further support and collect outcomes information.
Result:
36 callers were referred to a navigator during the pilot. Subsequently, 23 patients (64%) reported discussing clinical trials with their oncologist. Six of these approached a specific trial, with one enrolling, four being excluded due to not meeting eligibility criteria, and one not enrolling due to the trial being closed. Three others choose standard of care treatment over trials and one declined treatment. Two had doctors advise against trials in favor of other options. Three had disease progression preventing further trial consideration and one passed away. Seven of the 23 were still discussing trials at the end of follow up. Six of the initially referred callers chose not to discuss trials with their oncologist. The majority of these (five) reported not feeling a need to discuss trials due to having stable disease on a current treatment. The remaining caller reported feeling a lack of doctor support as reason for choosing not to discuss. Seven of the 36 initial callers were lost to follow-up.
Conclusion:
Given that 64% of the patients in the pilot program reported discussing trials with their oncologist, a personalized support program may represent an effective means of increasing clinical trial participation among lung cancer patients. This program will be expanded to include more participants and gather more information on barriers to clinical trial participation.
