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67P Challenges to Molecular Testing for Selecting Targeted Therapies for Oncology Patients in India

V. P. B. Koyyala, P. S. Kulkarni,V. Goel, S. C. Goteti, S. Raj Purohit,A. Jajodia, S. R. Ch,P. Medisetty,P. Goyal,M. La Mantia,C. Dodagoudar,S. Pasricha, S. S. Sen

Annals of oncology(2021)

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摘要
Usage of appropriate targeted therapies requires molecular tests to select appropriate patients. These tests are used globally to help oncology patients get appropriate therapy, however, there are many challenges faced by Indian oncologists to prescribe these tests due to multiple reasons of heterogeneity in practice and some unique situations. This study was done to evaluate such challenges faced by Indian medical oncologists. This is a cross-sectional descriptive study conducted in various Oncology institutions across India using digital survey questionnaires via electronic and social media platforms after consent at the beginning of the survey. A total of 88 medical oncologists were contacted, 23 doctors rejected to participate in the survey. Out of 65 oncologists who gave consent and responses, 44.6% of them were in academic institutions, and an equal number of them were in either private or corporate hospitals. About 18.4% of them are practicing in a public-funded oncology setup. 67% of them answered that about 10-50% of patients they encounter required any sort of molecular test that would alter the management. 86.2% of them opined that the main challenge in ordering the molecular test required is the affordability of targeted therapy, followed by non-affordability for getting the prescribed molecular test (73.8%). Nearly 4.6% of physicians found problems in logistics for the transport of tissues for the molecular lab. Among those who were able to do the molecular testing in required patients, 15.4% were using Single gene testing while 29.2% were using multi-gene panel assays. Of all, 21.5% of medical oncologists opined that in more than 10% of cases they encounter, we're needing a rebiopsy due to inadequate tissue for testing. Of all the tests that were ordered, Lung cancer is the most common cancer that required molecular testing for decision making (92.3%). About 61.5% of medical oncologists said that they were able to use immunotherapy in less than 5% of indicated patients and the most common reason for this is non- affordability (95.4%). Despite advancements in oncology, there are basic and unique challenges faced by oncologists in India to get a molecular test done for a cancer patient.
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