Virtual Library
Start Your Search
Achintya Jaitly
Author of
-
+
MA07 - Towards Survivorship: The Landscape, Supports and Barriers (ID 904)
- Event: WCLC 2018
- Type: Mini Oral Abstract Session
- Track: Advocacy
- Presentations: 1
- Moderators:
- Coordinates: 9/24/2018, 13:30 - 15:00, Room 205 AC
-
+
MA07.10 - Utilizing a Personalized Navigation Program to Identify Barriers and Increase Clinical Trial Participation Among Lung Cancer Patients (ID 13482)
14:35 - 14:40 | Author(s): Achintya Jaitly
- Abstract
- Presentation
Background
Only about 5% of cancer patients participate in clinical trials. We previously conducted a survey of U.S. lung cancer patients and found that only 22% reported discussing clinical trials with their oncologist at the time of making treatment decisions. We hypothesized that a personalized navigation program could both increase rates of trial discussion and identify barriers to participation among lung cancer patients.
a9ded1e5ce5d75814730bb4caaf49419 Method
We asked callers to Lung Cancer Alliance's 1-800 support line if they had considered clinical trial participation and referred willing callers to a navigator for further discussion. Navigators provided basic clinical trial education and a personalized list of trial matches. 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.
4c3880bb027f159e801041b1021e88e8 Result
We referred sixty callers to a navigator. Only 43% of callers reported a prior clinical trials conversation with their provider. Patients who had not started treatment or were on first-line treatment reported lower discussion rates (30%) than those on later treatment lines (60%). Among patients with follow up, 13 of 20 patients who had not discussed trials with their provider reported doing so after navigation. Ten of eleven patients that had a previous trial conversation initiated an additional one. Primary reasons given for not talking discussing after navigation were having stable disease on a current treatment or waiting for a clinical result. Ten patients reported contacting a trial. Primary reasons for not contacting a trial after discussion were disease progression, choosing a standard of care alternative, or waiting for a clinical result. Four patients have enrolled on a trial. Two patients were determined ineligible for a trial they approached for not meeting listed eligibility criteria and two for reasons not appearing in public trial information.
8eea62084ca7e541d918e823422bd82e Conclusion
We identified barriers throughout the clinical trials consideration and enrollment process. One set of barriers was related to care coordination, as exemplified by low rates of trial discussion during early stages of treatment and patient reports of delayed trial consideration when currently receiving treatment or waiting on a clinical result. Communication of trial information was another area presenting barriers, as exemplified by exclusion of patients from trials for reasons not readily apparent from public trial information. Improving integration of trial discussion during care and ensuring availability of accurate, updated trial information may be essential to increase trial participation.
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.
-
+
P2.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 964)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
-
+
P2.15-13 - Implementation of a Democratized Approach to Multi-Omic Molecular Profiling Via the LungMATCH Program. (ID 13329)
16:45 - 18:00 | Author(s): Achintya Jaitly
- Abstract
Background
For metastatic non-small cell lung cancer (NSCLC) guidelines include molecular testing for actionable biomarkers and recommend broad profile testing. Previous studies indicate that many patients with NSCLC are not receiving testing, even for actionable changes in EGFR, ALK, and ROS, BRAF, and PD-L1. There are widespread gaps in the community setting and Lung Cancer Alliance data shows that less than 50% of callers to the patient HelpLine have had molecular testing on their lung cancer.
a9ded1e5ce5d75814730bb4caaf49419 Method
The LungMATCH molecular testing program is operationalized via a turn-key precision medicine (PM) operation system. This approach provides a standardized workflow from tissue acquisition through multi-omic molecular profiling, treatment history integration, and AI-based computational analysis to produce a treatment decision support tool of therapeutic options matched to the patient. Longitudinal outcome is collected on every patient along with treatment decisions and patient experience.
4c3880bb027f159e801041b1021e88e8 Result
The majority of the patient referrals (72%) came from non-academic centers across a wide geographic region that covered nearly 75% of the United States (36/50 states). Barriers to signing informed consent and completing biopsy have been identified including: patients in poor health, cost concerns, unsupportive physicians, and patient loyalty to the physician (discomfort with advocating for testing). For patients who have received reports, 72% (12/17) had actionable genomic alterations that indicated either a standard of care agent or a clinical trial. An additional 82% (9/11) had actionable proteomic findings and 31% (5/16) had high tumor mutational burden.
8eea62084ca7e541d918e823422bd82e Conclusion
There is broad patient interest in accessing PM information but still many barriers to widespread adoption. The LungMATCH program provides a turn-key solution to help provide a facile means to “democratize” access to PM information unbound by geography or community/academic setting. Importantly, the majority of patients who received a completed profiling report had actionable molecular alterations, which underscores the potential impact of testing. Treatment decisions and patient outcomes continue to be followed.
6f8b794f3246b0c1e1780bb4d4d5dc53
