Video Intervention to Address Pre-Test Patient Education for Tumor Genomic Testing

Thousands of patients are diagnosed with metastatic cancers each year and somatic (tumor) next generation sequencing (NGS) testing is increasingly important for the treatment of these cancers. Professional guidelines state that treating oncologists should discuss with patients prior to testing the possibility of incidental germline findings and disease-specific limitations in clinical utility and interpretation of somatic (tumor) next generation sequencing (NGS) results. However, oncologists have varied understanding of genetics and time limitations make it challenging for providers to adequately inform their patients about tumor NGS within the context of routine clinical care. As a result, pre-test education is often incomplete and has significant variability across providers resulting in inequitable care. The overall goal of this project is to develop and evaluate series of videos to be used for pre-test education of patients who undergo tumor NGS testing as part of their clinical care. Prior to project initiation, we conducted a provider survey to assess current provider practice as it pertains to tumor NGS testing and patient focus groups to identify common areas of misinformation and preferences for information presentation. Based on this provider and patient feedback and national recommendations, we will develop 3 brief animated videos (approximately 2 minutes in length): a tumor-agnostic video (Aim 1) as well as videos that contain tumor type-specific content for patients with metastatic lung cancer (MLC) or metastatic breast cancer (MBC) (Aim 2). Metastatic cancer patients will be invited to view this video in-office when their oncologists plan to order tumor NGS testing. Study participants will complete questionnaires to assess message-specific and general genomics knowledge, tolerance of uncertainty, and provider trust both pre- and post-video viewing. Our approach is innovative because in addition to knowledge, we will evaluate tolerance for uncertainty and trust in provider, which have not been investigated in this context. The study is significant because we will determine if effective pre-tumor NGS education can be achieved in a very brief, highly scalable, video message. Our long-term goal is to study the video in a randomized-controlled, multi-center trial in academic and community settings with diverse demographics.