Assessing patient preferences and perspectives of precision cancer medicine: A systematic review.


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Ben Fulton1,Robert Jones1,James Paul1
1Glasgow CRUK Clinical Trials Unit

Abstract

Background

Background: The concept of precision cancer medicine (PCM), using factors of individual patient variability to confer treatment strategies, is creating opportunities for developing novel therapies with durable clinical benefit. This shift in treatment paradigm harnesses key components of individual patient variability and, for precision cancer medicine to fulfil its promise, it is crucial that the preferences and perspectives of patients are incorporated into its delivery. The aim of this systematic review is two fold: to determine the current state of knowledge as to which factors are important to patients in order to make PCM an attractive therapeutic intervention and the associated patient-centric thresholds of trade-offs for these factors.

Method

Methods: We conducted a systematic literature search of Cochrane Library, MEDLINE, EMBASE and PubMed databases for relevant articles. The reviewer independently selected articles and extracted data.

Results

Results: We identified 3 suitable studies assessing patient attitudes/preferences of precision cancer medicine. The results demonstrated some common patient-centric factors important to decision-making regarding PCM, including efficacy of available therapies, cost of genomic testing, predictive value of any testing, invasiveness of testing and effect on quality of life or side-effects. There were a range of methodologies employed within the literature including some studies using both patients and healthy volunteers. Two studies highlighted the differential patient preferences regarding PCM between patients treated with curative versus palliative intent.

Conclusion

Conclusions: This systematic review confirms some common patient-centric factors which affect willingness to participate and preferences on genomic testing in PCM. Some of these principles can be extrapolated to the wider implementation of PCM as standard of care, but this review demonstrates the paucity of empirical evidence examining patient perspectives on the role and acceptability of conceptual precision medicine as well as threshold of trade-offs for its implementation throughout the wider cancer community.