Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Clinicians’ and patients’ knowledge, understanding and communication related to biomarkers in cancer care: a systematic review (#200)

Rehana Abdus Salam 1 2 , Andrea Smith 1 , Kate L.A. Dunlop 1 , Tuba Gide 2 3 , James Wilmott 2 3 , Anne E Cust 1 2
  1. The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia, Sydney
  2. Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia, Sydney
  3. Charles Perkins Centre, The University of Sydney, Sydney, New south Wales, Australia, Sydney

Aims:Clinicians and patients face distinct challenges related to the role and value of biomarker testing to inform personalised prognosis and treatment in cancer care. We aimed to synthesise evidence on clinicians’ and patients’ knowledge, understanding and communication along with associated factors related to the use of biomarker testing using the Theoretical Domains Framework.

Method: We searched MEDLINE, EMBASE, Web of Science Index Medicus, CINAHL, Lilacs, CENTRAL (Cochrane Library) and Google Scholar until July 2024. Studies assessing knowledge, understanding and communication or associated factors related to biomarkers in cancer care among clinicians and patients were included.

Results: A total of 80 studies were included: 50 quantitative, 26 qualitative, and four mixed methods studies. 39 studies reported clinician-related outcomes (33 reported clinician knowledge and 15 reported communication); 24 studies reported patient-related outcomes (20 reported patient knowledge and 19 reported communication); and 23 studies reported associated factors. Clinicians had inconsistent knowledge and limited skills related to interpreting biomarker test results and communicating findings of uncertainty and its implications for patients. Lack of expert consensus and clinical guidelines for biomarker testing led to uncertainties. Excessive turn-around times, lack of insurance coverage, and logistical requirements hindered implementation. Patients highlighted the need for more information about biomarker testing and its potential benefits but were optimistic about contributing to research even if it was unlikely to provide them with personal benefits. Expectations of benefits to patients from biomarker testing did not always align with the probability of successful outcome.

Conclusion:This review highlights gaps in knowledge and communication related to biomarker testing in cancer care. Owing to the complex and evolving scope of biomarker testing, additional training to improve knowledge and communication skills are crucial. Future strategies should be targeted towards reducing uncertainties including setting up institutional guidelines and multi-disciplinary team coordination for shared decision making.