Implementation of Precision Oncology in Clinical Practice: Results of a National Survey for Health Care Professionals

• Published in: The oncologist (Dayton, Ohio) Vol. 28; no. 6; pp. e324 - e330
• Main Authors: Fasola, Gianpiero, Barducci, Maria C, Pelizzari, Giacomo, Grossi, Francesco, Pinto, Carmine, Daniele, Bruno, Giordano, Monica, Ortega, Cinzia, Silva, Rosa Rita, Tozzi, Valeria D, Cavanna, Luigi, Aprile, Giuseppe
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01-06-2023
• Subjects: Beliefs, opinions and attitudes; European s; Medical personnel; Oncology; Practice; Italy; healthcare management research; healthcare innovation implementation; national survey; healthcare delivery; molecular tumor boards; precision oncology implementation
• ISSN: 1083-7159; 1549-490X
• DOI: 10.1093/oncolo/oyad020

Abstract
Background
Two main aspects lead the implementation of precision oncology into clinical practice: the adoption of extended genome sequencing technologies and the institution of the Molecular Tumor Boards (MTBs). CIPOMO (Italian Association of Heads of Oncology Department) promoted a national survey across top health care professionals to gain an understanding of the current state of precision oncology in Italy.
Methods
Nineteen questions were sent via the SurveyMonkey platform to 169 heads of oncology departments. Their answers were collected in February 2022.
Results
Overall, 129 directors participated; 113 sets of answers were analyzed. Nineteen regions out of 21 participated as a representative sample of the Italian health care system. The use of next-generation sequencing (NGS) is unevenly distributed; informed consent and clinical reports are managed differently, as the integration of medical, biologic, and informatics domains in a patient-centered workflow is inconsistent. A heterogeneous MTB environment emerged. A total of 33.6% of the responding professionals did not have access to MTBs while 76% of those who have did not refer cases.
Conclusions
NGS technologies and MTBs are not homogeneously implemented in Italy. This fact potentially jeopardizes equal access chances to innovative therapies for patients. This survey was carried out as part of an organizational research project, pursuing a bottom–up approach to identify the needs and possible solutions to optimize the process. These results could be a starting point for clinicians, scientific societies, and health care institutions to outline the best practices and offer shared recommendations for precision oncology implementation in current clinical practice.
To obtain a clearer picture of the state of precision oncology in Italy, a national survey was conducted to investigate the implementation of next-generation sequencing technologies and the establishment of molecular tumor boards. The results of this survey are reported here.