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Andrea Ferris
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ES05 - Collaboration Between Stakeholders to Improve Lung Cancer Research (ID 773)
- Event: WCLC 2018
- Type: Educational Session
- Track: Advocacy
- Presentations: 1
- Moderators:
- Coordinates: 9/25/2018, 15:15 - 16:45, Room 205 AC
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ES05.02 - Can Patient Groups and Regulatory Bodies Work Together to Make Clinical Research Easier? (ID 11371)
15:35 - 15:55 | Presenting Author(s): Andrea Ferris
- Abstract
Abstract not provided
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MA07 - Towards Survivorship: The Landscape, Supports and Barriers (ID 904)
- Event: WCLC 2018
- Type: Mini Oral Abstract Session
- Track: Advocacy
- Presentations: 2
- Moderators:
- Coordinates: 9/24/2018, 13:30 - 15:00, Room 205 AC
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MA07.02 - Line of Therapy and Patient Preferences Treating Lung Cancer: A Discrete-Choice Experiment (ID 14107)
13:35 - 13:40 | Presenting Author(s): Andrea Ferris
- Abstract
- Presentation
Background
Patient preferences now play an important role in cancer research, regulatory science, and value assessment. While there is a growing literature exploring the preference of patients with lung cancer, few studies have explored how preferences vary with patients’ treatment experience. We sought to quantify patient preferences for the benefits and risks of therapy and explore how they vary across line of treatment.
a9ded1e5ce5d75814730bb4caaf49419 Method
Preferences were estimated using a discrete choice experiment (DCE) developed in partnership with a patient and stakeholder advisory boards. A D-optimal experimental design was used to generate 3 blocks of 9 choice tasks spanning five attributes: progression-free survival (PFS), short-term side effects, long-term side effects, risk of developing late-onset side effects, and mode of administration – each defined across 3 relevant levels. A diverse sample was recruited via email sent to the LUNGevity lung cancer patient database and via social media. A choice mode was estimated use a conditional logistic regression where the dependent variable was the respondents preferred treatment in each profile. The relative attribute importance (conditioned on the chosen attribute levels) was then compared across the respondents’ self-reported line of treatment.
4c3880bb027f159e801041b1021e88e8 Result
In total we had 350 eligible respondents, of which 279 (80%) completed as least on DCE task of which 3% did not receive a pharmacotherapy, 39% received first line therapy, and 58% had two or more lines of theory. As with previous studies, PFS was the most important attribute for patients and was similarly valued (P=0.406) among first- and later (second lines and more) lines of treatment (33.4% v 33.8%). Patients on first-line treatment placed great emphasis (P<0.001) on long-term side (18.9% v 14.1%) and late onset side effects (15.3% v 10.3%), but less emphasis (P<0.001) on short-term side effects (27.8% v 29.8 %) and mode of administration (4.6% v 12.0%) than those on later lines.
8eea62084ca7e541d918e823422bd82e Conclusion
Population estimate of patient preference remain important, but more effort is needed to understand how patient preference vary across patient with different backgrounds and treatment experiences. We show that line of treatment does not effect how patients value time, but their experience may have an impact on treatment characteristics. Latent class analysis may allow for the identification of groups with similar preferences that could allow for multivariate analyses to explain preference heterogeneity.
6f8b794f3246b0c1e1780bb4d4d5dc53Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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MA07.09 - Willingness to Perform Multiple Biopsies to Improve Quality of Lung Cancer Care: Understanding the Oncologists’ Perspective (ID 14096)
14:30 - 14:35 | Author(s): Andrea Ferris
- Abstract
- Presentation
Background
Biomarker testing of advanced-stage non-small cell lung cancer (NSCLC) at the time of diagnosis is required to determine if a patient will benefit from a targeted therapy or immunotherapy. A patient may, however, need additional biopsies (rebiopsy) if the cancer recurs to determine the next line of therapy or to determine eligibility for a new drug or participation in a clinical trial. A LUNGevity study, conducted with 340 patients, revealed that patients were willing to undergo rebiopsies if that meant access to additional treatment options at the time of recurrence. However, only 36% of patients reported that their doctors recommended repeat biopsies at progression.
a9ded1e5ce5d75814730bb4caaf49419 Method
To understand this patient-physician communications gap, we conducted an IRB-approved semi-structured survey-based study of 130 oncologists from academic research centers, community cancer centers, and private practice.
4c3880bb027f159e801041b1021e88e8 Result
Of the 130 oncologists surveyed,
- Ninety percent of oncologists reported recommending a rebiopsy to their patients. However, when stratified by advanced-stage patient volume, oncologists with higher advanced-stage patient volumes reported higher rebiopsy and testing rates than those with low volumes (95% vs. 78%, p<0.05). Only 29% of the oncologists prescribed a rebiopsy in the past one year.
- Major barriers to rebiopsy reported by oncologists included cost/reimbursement of a rebiopsy and treatment delay for 2nd- or subsequent lines of therapy
- Among the types of biomarker testing performed at the time of progression, oncologists were more likely to prescribe testing for biomarkers with approved treatments (driver mutations – 94%, PD-L1 – 85%) unlike biomarkers for treatments in clinical development (43%) (p<0.05).
- A forward linear regression analysis revealed that positive predictors of rebiopsy included treatment at a NCI Designated Cancer Center, while treatment at a community cancer center or private practice, presence of driver mutations at the time of diagnosis, and performance status of patient were negative predictors of rebiopsy
- When presented with specific treatment scenarios for biomarkers (EGFR and ALK) that have 2nd-line treatment options, oncologists differed in their approach, suggesting a need for oncologist education about rebiopsying and subsequent biomarker testing
8eea62084ca7e541d918e823422bd82e Conclusion
Our study demonstrates that rebiopsy practices vary by practice settings and volume of advanced-stage lung cancer patients. Even when rebiopsies are prescribed, a comprehensive biomarker profile of the tumor may not be obtained, due to variations in tests requested. A major implication is the need for appropriate oncologists’ education to ensure practice change for delivery of optimal care to lung cancer patients.
6f8b794f3246b0c1e1780bb4d4d5dc53Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.
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P1.02 - Advocacy (Not CME Accredited Session) (ID 934)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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P1.02-09 - Identifying Gaps in Messaging for Biomarker Testing in the Lung Cancer Community: Need for Consistent and Actionable Messaging (ID 14089)
16:45 - 18:00 | Author(s): Andrea Ferris
- Abstract
Background
Since 2015, the US Food and Drug Administration has approved more than fifteen lung cancer treatment approaches, the majority of which are biomarker-driven. However, not all eligible patients benefit from these treatments, partly due to lack of tumor testing. To help assess whether inconsistent messaging could be a contributor to the suboptimal biomarker testing rates, we conducted a messaging audit to determine the messages being conveyed to lung cancer patients and healthcare providers (HCP).
a9ded1e5ce5d75814730bb4caaf49419 Method
We analyzed marketing and education materials from 7 lung cancer patient advocacy groups (PAGs), 2 professional associations, 10 pharmaceutical companies, and 5 diagnostic companies that provide genomic testing to lung cancer patients. The materials included were those used by PAGs geared toward patients and those used by industry and testing companies for both patients and HCPs (oncologists). Privately used marketing materials were solicited from pharmaceutical companies. All materials were de-identified, and the rubric of analysis involved assessing whether materials answered six key questions: What is biomarker testing? Why is it important? Who (which patients) should get tested? When (at what point in the treatment journey)? How and where is testing done?
Materials were audited by two independent reviewers and checked for inter-reviewer reliability. The audit was presented to a stakeholder group (organizations included in the audit) to elicit feedback, discuss gaps, and identify solutions.
4c3880bb027f159e801041b1021e88e8 Result
When analyzing patient-facing materials, PAGs were successful in answering Why, Who, and What, whereas pharmaceutical industry-developed campaigns were adept at answering the Why, How, and What. Deeper analysis revealed that patients were receiving mixed messages from PAGs and industry developed-campaigns. PAGs analyzed did not produce HCP-facing materials. However, industry-generated HCP-facing materials’ strength was their responses to Why patients should be tested and their gap was their responses to When patients should be tested. A qualitative trend noted was that most HCP-facing materials did not focus on the benefit to a patient that testing provides. All materials audited lacked a consistent “call-to-action” to patients.
8eea62084ca7e541d918e823422bd82e Conclusion
Our audit identified gaps in education materials, and highlights the importance of consistent and actionable messages for lung cancer patients and HCPs so that the importance of biomarker testing is appropriately conveyed. When presented to the stakeholder group, meeting participants agreed that all materials should at least answer the Why, Who, and When. Furthermore, they suggested that educational materials should include the importance to patients of tissue–based biopsies and tissue acquisition for biomarker testing.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P3.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 981)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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P3.15-09 - Are Lung Cancer Patients Receiving Education Materials? The Healthcare Provider Perspective on Distribution Gaps and Possible Solutions (ID 14049)
12:00 - 13:30 | Presenting Author(s): Andrea Ferris
- Abstract
Background
While new treatments for lung cancer bring new hope, they can also make understanding a lung cancer diagnosis and making treatment decisions a challenge for both patients and caregivers. Education is imperative to understanding the diagnosis and making informed treatment decisions. However, many patients and their caregivers report that they do not receive materials from their doctors. We fielded a study of healthcare providers (HCP) to understand their attitudes and practices on disseminating patient education for lung cancer.
a9ded1e5ce5d75814730bb4caaf49419 Method
We conducted an IRB-approved sequential mixed-method study of 216 HCPs (130 oncologists, 52 pulmonologists, and 34 nurse navigators/clinic or hospital administrators) from academic research centers, community cancer centers, and private practice to get a full and broad picture of education for lung cancer patients based on the specific role each HCP group plays in the treatment journey. The quantitative survey was followed by a qualitative interview of five HCPs to contextualize the survey findings. Questions of the study delved into perception, usage, distribution, and development of education materials.
4c3880bb027f159e801041b1021e88e8 Result
Of the HCPs surveyed, surprisingly only 75% report that lung cancer educational materials are distributed. Nurse navigators/clinic administrators were more likely to distribute patient education materials than oncologists and pulmonologists (p<0.05). Notably, there is a discrepancy in who actually does the distributing: nurse navigators and community cancer center administrators say oncologists most often distribute them (80%), while oncologists and pulmonologist claim they only distribute some of the time (56%). Information format also was reported as a factor in distribution; HCPs are interested in information that can be both electronic and printable (79% of HCPs report that they distribute information via printed resources, and 59% of them still prefer printed materials, given the choice). Overall, community cancer centers report a higher rate of distribution than private practices and hospitals (p<0.05). However, there is typically not a point person for material review in any of these settings, and most HCPs report using information from multiple sources, such as self-created materials and materials created by other organizations.
8eea62084ca7e541d918e823422bd82e Conclusion
Distribution practices for educational materials are not standard and tend to be subject to the HCP’s own discretion, leading to inconsistent delivery of materials. In-depth interviews with HCPs suggest possible solutions, including customization to patient/caregivers’ unique type of lung cancer, availability of multiple formats of education materials for distribution, and white-labeling of materials to allow re-branding to an HCP’s unique practice setting.
6f8b794f3246b0c1e1780bb4d4d5dc53
