Another genomic testing provider, Caris Life Sciences based in Irving, Texas, is currently developing educational content to be released this summer that oncologists can share with their patients. You can spend a half-hour explaining to oncologists how wonderful the technology is. But what doctors want to know is how this relates to their patients,” said Chadi Nabhan, MD, FACP, chair of the Precision Oncology Alliance at Caris. “We’re trying to show them the impact [of sequencing] on clinical care and how they can communicate that.”

Last month, Foundation Medicine launched a new TV spot as part of its campaign “Start With Step One,” meant to encourage patients to discuss the FoundationOne CDx genomic test for people with advanced cancer with their physician. This version intentionally includes a father and daughter talking with an oncologist in her office.

“We wanted to involve the oncologist in the commercial because we see there’s a lack of awareness on both sides,” said Cindy Perettie, chief executive officer of Foundation Medicine (the company was a platinum sponsor of the 2020 COA meeting). “The field is moving so quickly [that] we’re seeing new drug approvals almost every week. As an oncologist, how do you stay on top of that? And then how do you keep it straight when making treatment decisions with every patient? This genomic information is integral to how you approach treatment.”

Despite such efforts by commercial labs to sign up the nation’s oncologists, experts say wider use of genomic tests among community providers will occur when they get more involved in using and interpreting them. That will require changing the practice patterns and culture of smaller providers, said Timothy Chan, MD, PhD, chair of the Center for Immunotherapy and Precision Immuno-Oncology at the Cleveland Clinic in Ohio. Unlike oncologists at large academic centers, community providers might have fewer peers nearby to discuss new developments, including journal articles or findings from conferences, and may feel less pressure to integrate such protocols into their practices.


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“Whatever you can do to make these NGS diagnostics more accessible will help adoption,” said Dr Chan, adding that the CVS Health pilot program is a move in the right direction to make testing more mainstream and create a larger network of participating oncologists.

Part of building that ecosystem is creating local molecular tumor boards in which doctors regularly review genomic results and collaborate on treatment recommendations, said Dr Schwartzberg. “The number of local boards is increasing. At my practice, we hold them every other week,” he added.

Another strategy to engage community oncologists is developing sequencing technology they will be able to easily use in their own labs, rather than having to send patient samples out to a third-party vendor. That’s the thinking behind Illumina’s new comprehensive genomic profiling test — currently in development — that analyzes 523 genes in key cancer-related pathways. “Once we get testing approval and reimbursement, we’ll have broader adoption. If clinical utility is demonstrated and we can get more labs in more hospitals using it, more patients will get access to it earlier,” said Kevin Keegan, senior director of clinical oncology marketing at genetic sequencing machine manufacturer Illumina. “With each new gene discovery and drug label expansion, the need for NGS testing is greater and greater.”

References

  1. Kirkwood, MK, Hanley A, Bruinooge SS, et al. The state of oncology practice in America, 2018: Results of the ASCO practice census survey. J Oncol Pract. 2018;14(7):e412-e420.
  2. Levit LA, Kim ES, McAneny BL, et al. Implementing precision medicine in community-based oncology programs: three models. J Oncol Pract. 2019;15(6):325-329.
  3. Centers for Medicare & Medicaid Services (CMS). CMS expands coverage of next generation sequencing as a diagnostic tool for patients with breast and ovarian cancer [press release]. Published January 27, 2020. Accessed May 21, 2020.