Table A2.
Themes Related to Physicians' Predictions About Patients Whom They Would and Would Not Test
| Theme | Physicians (%) | Examples |
|---|---|---|
| Patients to Be Tested (n = 112) | ||
| Cancer type | 54 | Lung, mesothelioma, thymoma, breast, colon, pancreatic, esophageal, ovarian, endometrial, melanoma, prostate, GIST, glioma, meningioma, pituitary, sarcoma, ALL, AML, NHL, MM, MDS, unknown primary, rare tumor types |
| Cancer stage | 29 | Stage IV, high-risk stage III, recurrent disease |
| Absolute responses | 16 | Test all patients, test as many patients as possible, test all patients receiving active treatment, test all patients at diagnosis, test all phase one patients, test all patients if test is free |
| Tumor characteristics | 14 | Chemotherapy refractory, rapid progression, histology (eg, squamous), deep melanoma |
| Testing informs treatment | 10 | Clinical trial enrollment, risk stratification, choice of therapy |
| Patient characteristics | 7 | Young patients, patients interested in clinical trials or research, well-educated patients, nonsmokers, patients with family history of cancer, those with multiple malignancies, those at risk for second malignancy |
| Genomic status | 7 | ER- and HER2-positive, triple-negative breast cancer, cases of MEN-1, need to evaluate for PI3KCA, KRAS, and BRAD mutations, known negative for routinely tested mutations, normal-karyotype hematologic diseases |
| Other | 5 | Patients needed to establish database for correlating tumor genetics to treatment response in situations of proven clinical benefit; patients will want testing to guide decision making |
| Patients Not to Be Tested (n = 53) | ||
| Cancer stage | 42 | Early-stage tumors, stage I/II |
| Cancer type | 40 | Bladder, prostate, testicular, sarcoma, DCIS or LCIS, ovarian, vulvar, cervical, AML, hematologic malignancies, benign tumors |
| Patient characteristics | 32 | Patients receiving palliative or supportive care, patients who are debilitated or have poor performance status |
| Absolute responses | 8 | Most patients do not need testing, will not test any of my patients, will not test inpatients |
| Tumor characteristics/genomic status | 6 | Low-risk cancers, curable tumors, early recurrence, low-grade tumors, high-grade tumors, ER- and HER2-positive tumors or histology (eg, squamous cell), AML with low blast count |
| When does not inform treatment | 6 | Patients who discontinue treatment, patients eligible for clinical trials, patients undergoing long-term follow-up |
| Other | 9 | Patients who do not have enough tissue, patients with low probability of genomic abnormalities, second opinions, few or no relevant or actionable genes for my patients, patients who do not consent |
Abbreviations: ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; DCIS, ductal carcinoma in situ; ER, estrogen receptor; GIST, GI stromal tumor; HER2, human epidermal growth factor receptor 2; LCIS, lobular carcinoma in situ; MDS, myelodysplastic syndrome; MEN-1, multiple endocrine neoplasia type 1; MM, multiple myeloma; NHL, non-Hodgkin lymphoma.