Cancer Patient-Reported Preferences and Knowledge for Liquid Biopsies and Blood Biomarkers at a Comprehensive Cancer Center
Received 27 October 2019
Accepted for publication 29 January 2020
Published 13 February 2020 Volume 2020:12 Pages 1163—1173
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Yong Teng
Min Joon Lee,1,2 Katrina Hueniken,3 Nathan Kuehne,1 Lin Lu,4 Shirley Xue Jiang,1 Badr Id Said,1 Alex McCartney,1 Yizhuo Gao,1 Mindy Liang,3 Tamara Obuobi,1 Hadas Sorotsky,1 Lawson Eng,1 M Catherine Brown,3 Wei Xu,4 Geoffrey Liu1,3,5
1Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; 2Faculty of Medicine, University of Toronto, Toronto, ON, Canada; 3Department of Medical Biophysics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; 4Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; 5Department of Epidemiology, Dalla Lana School of Public Health, Toronto, ON, Canada
Correspondence: Geoffrey Liu
Princess Margaret Cancer Centre, 610 University Avenue, Toronto ON M5G 2M9, Canada
Tel +1 416-946-4501 (ext 3479)
Fax +1 416-946-4501 (ext 3067)
Background: Blood-based biomarkers (liquid biopsy) are increasingly used in precision oncology. Yet, little is known about cancer patients’ perspectives in clinical practice. We explored patients’ depth of preferences for liquid vs tissue biopsies and knowledge regarding the role of blood biomarkers on their cancer.
Methods: Three interviewer-administered trade-off scenarios and a 54-item self-administered questionnaire were completed by cancer outpatients across all disease sites at the Princess Margaret Cancer Centre.
Results: Of 413 patients, 54% were female; median age was 61 (range 18– 101) years. In trade-off scenario preference testing, 90% (n=372) preferred liquid over tissue biopsy at baseline; when wait times for their preferred test were increased from 2 weeks, patients tolerated an additional mean of 1.8 weeks (SD 2.1) for liquid biopsy before switching to tissue biopsy (with wait time 2 weeks). Patients also tolerated a 6.2% decrease (SD 8.8) in the chance that their preferred test would conclusively determine optimal treatment before switching from the baseline of 80%. 216 patients (58%) preferred liquid biopsy even with no chance of adverse events from tissue biopsy. Patients’ knowledge of blood-based biomarkers related to their cancer was low (mean 23%); however, the majority viewed development of blood biomarkers as important.
Conclusion: Patients had limited understanding of cancer-specific blood-based biomarkers, but 90% preferred liquid over tissue biopsies to assess biomarkers. There was little tolerance to wait longer for results, or for decreased test-conclusiveness. Developing accurate, low-risk tests for cancer diagnosis and management for blood biomarkers is therefore desirable to patients.
Keywords: blood biomarker, liquid biopsy, precision oncology, patient preference, patient knowledge
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