Cancer Management and Research (Feb 2020)

Cancer Patient-Reported Preferences and Knowledge for Liquid Biopsies and Blood Biomarkers at a Comprehensive Cancer Center

  • Lee MJ,
  • Hueniken K,
  • Kuehne N,
  • Lu L,
  • Jiang SX,
  • Id Said B,
  • McCartney A,
  • Gao Y,
  • Liang M,
  • Obuobi T,
  • Sorotsky H,
  • Eng L,
  • Brown MC,
  • Xu W,
  • Liu G

Journal volume & issue
Vol. Volume 12
pp. 1163 – 1173

Abstract

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Min Joon Lee,1,2 Katrina Hueniken,3 Nathan Kuehne,1 Lin Lu,4 Shirley Xue Jiang,1 Badr Id Said,1 Alex McCartney,1 Yizhuo Gao,1 Mindy Liang,3 Tamara Obuobi,1 Hadas Sorotsky,1 Lawson Eng,1 M Catherine Brown,3 Wei Xu,4 Geoffrey Liu1,3,51Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; 2Faculty of Medicine, University of Toronto, Toronto, ON, Canada; 3Department of Medical Biophysics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; 4Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; 5Department of Epidemiology, Dalla Lana School of Public Health, Toronto, ON, CanadaCorrespondence: Geoffrey LiuPrincess Margaret Cancer Centre, 610 University Avenue, Toronto ON M5G 2M9, CanadaTel +1 416-946-4501 (ext 3479)Fax +1 416-946-4501 (ext 3067)Email [email protected]: Blood-based biomarkers (liquid biopsy) are increasingly used in precision oncology. Yet, little is known about cancer patients’ perspectives in clinical practice. We explored patients’ depth of preferences for liquid vs tissue biopsies and knowledge regarding the role of blood biomarkers on their cancer.Methods: Three interviewer-administered trade-off scenarios and a 54-item self-administered questionnaire were completed by cancer outpatients across all disease sites at the Princess Margaret Cancer Centre.Results: Of 413 patients, 54% were female; median age was 61 (range 18– 101) years. In trade-off scenario preference testing, 90% (n=372) preferred liquid over tissue biopsy at baseline; when wait times for their preferred test were increased from 2 weeks, patients tolerated an additional mean of 1.8 weeks (SD 2.1) for liquid biopsy before switching to tissue biopsy (with wait time 2 weeks). Patients also tolerated a 6.2% decrease (SD 8.8) in the chance that their preferred test would conclusively determine optimal treatment before switching from the baseline of 80%. 216 patients (58%) preferred liquid biopsy even with no chance of adverse events from tissue biopsy. Patients’ knowledge of blood-based biomarkers related to their cancer was low (mean 23%); however, the majority viewed development of blood biomarkers as important.Conclusion: Patients had limited understanding of cancer-specific blood-based biomarkers, but 90% preferred liquid over tissue biopsies to assess biomarkers. There was little tolerance to wait longer for results, or for decreased test-conclusiveness. Developing accurate, low-risk tests for cancer diagnosis and management for blood biomarkers is therefore desirable to patients.Keywords: blood biomarker, liquid biopsy, precision oncology, patient preference, patient knowledge

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