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A randomized study of genetic education versus usual care in tumor profiling for advanced cancer in the ECOG‐ACRIN Cancer Research Group (EAQ152)
Author(s) -
Bradbury Angela R.,
Lee JuWhei,
Gaieski Jill Bennett,
Li Shuli,
Gareen Ilana F.,
Flaherty Keith T.,
Herman Benjamin A.,
Domchek Susan M.,
DeMichele Angela M.,
Maxwell Kara N.,
Onitilo Adedayo A.,
Virani Shamsuddin,
Park SuJung,
Faller Bryan A.,
Grant Stefan C.,
Ramaekers Ryan C.,
Behrens Robert J.,
Nambudiri Gopakumar S.,
Carlos Ruth C.,
Wagner Lynne I.
Publication year - 2022
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.34063
Subject(s) - medicine , randomized controlled trial , distress , psychosocial , cancer , anxiety , oncology , clinical psychology , psychiatry
Background Enthusiasm for precision oncology may obscure the psychosocial and ethical considerations associated with the implementation of tumor genetic sequencing. Methods Patients with advanced cancer undergoing tumor‐only genetic sequencing in the National Cancer Institute Molecular Analysis for Therapy Choice (MATCH) trial were randomized to a web‐based genetic education intervention or usual care. The primary outcomes were knowledge, anxiety, depression, and cancer‐specific distress collected at baseline (T0), posteducation (T1) and after results (T2). Two‐sided, 2‐sample t tests and univariate and multivariable generalized linear models were used. Results Five hundred ninety‐four patients (80% from NCI Community Oncology Research Program sites) were randomized to the web intervention (n = 293) or usual care (n = 301) before the receipt of results. Patients in the intervention arm had greater increases in knowledge ( P for T1‐T0 < .0001; P for T2‐T0 = .003), but there were no significant differences in distress outcomes. In unadjusted moderator analyses, there was a decrease in cancer‐specific distress among women (T0‐T1) in the intervention arm but not among men. Patients with lower health literacy in the intervention arm had greater increases in cancer‐specific distress and less decline in general anxiety (T0‐T1) and greater increases in depression (T0‐T2) in comparison with those receiving usual care. Conclusions Web‐based genetic education before tumor‐only sequencing results increases patient understanding and reduces distress in women. Refinements to the intervention could benefit low‐literacy groups and men.