Acceptability of circulating microRNAs for testicular germ cell malignancy: validation of an initial user consultation exercise


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Lorna Fern1,Michelle Greenwood2,Sue Brand3,Dan Stark4,Mathew Murray5
1University College London Hospitals,2St Bartholomew's Hospital London,3It’s in the Bag,4University of Leeds,5Cambridge University Hospitals

Abstract

Background

MicroRNAs of the miR-371~373 and miR-302/367 clusters are promising biomarkers for blood-based diagnosis and disease-monitoring of malignant germ-cell-tumours (MGCTs). These microRNA biomarkers have far superior sensitivity/specificity compared with current markers AFP and HCG. Consequently, circulating microRNA testing may replace serial CT scans in MGCT follow-up. We have now started to explore and address the acceptability of this approach, through user consultation exercises.

Method

In the pilot phase, three males (26-59y) participated in a four-hour in-depth workshop. Age at diagnosis was 23-42y; two participants had experienced relapse and all participants were currently in follow-up. The workshop comprised an interactive presentation and focus-group discussion, which was digitally recorded and transcribed verbatim for analysis. Qualitative content analysis of transcripts was used to identify key themes/subthemes. These themes/subthemes were then explored in a further workshop involving a large patient group.

Results

All participants favoured the circulating microRNA test over CT scans for MGCT follow-up. Four themes were identified, and subsequently validated, which favoured the microRNA test, namely:

 

  1. Sensitivity: increased compared with current AFP/HCG markers;
  2. Costs: reduced for both health service and patients (parking/time-off-work);
  3. Time: reduced compared with CT scan (both duration of test/scan and time for receiving results);
  4. Practicalities: ease-of-access to blood testing versus scanning (process/fasting/need for oral contrast/scan anxiety/claustrophobia).

Conclusion

These consultation exercises suggest that the new circulating microRNA test is acceptable to patients with many potential benefits conferred, versus traditional CT scan follow-up.