Breast cancer patient perspective on opportunities and challenges of a genetic test aimed to predict radio-induced side effects before treatment: Analysis of the Italian branch of the REQUITE project.
Breast cancer
Genetic test
Radiotherapy toxicity
Semi-structured interviews
Journal
La Radiologia medica
ISSN: 1826-6983
Titre abrégé: Radiol Med
Pays: Italy
ID NLM: 0177625
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
08
04
2021
accepted:
29
06
2021
pubmed:
17
7
2021
medline:
25
2
2023
entrez:
16
7
2021
Statut:
ppublish
Résumé
To explore breast cancer patient's perspective on future genetic testing for prediction of toxicity after breast radiotherapy (RT). The study involved patient enrolled in the Italian branch of the REQUITE project conducted at the National Cancer Institute in Milan. Semi-structured interviews were conducted within one month from the end of radiotherapy treatment by two radiation oncologists and a radiotherapy technician previously trained by a clinical psychologist with experience in the oncology field. Semi-structured interviews are characterized by a set of pre-defined questions and developed ad hoc by researchers in Leicester within the REQUITE project. The interview questions investigated interest in undergoing the genetic test and expectations on its usefulness and disadvantages. Eighteen interviews were conducted and analysed. Forty-five initial codes were combined into nine themes which were then clustered in two main macro-areas (i) Opportunities and (ii) Challenges. Overall, all patients understand the aim of the genetic test and considered its intrinsic opportunity to make the physician more confident with the treatment. Regarding side effects, most of patients felt prepared to RT but not without fear. Many women considered important to have the largest and reliable information, also about negative experiences. Prevailing emotions were anxiety and fear but not connected to genetic test's result. A genetic test could be an opportunity because generate knowledge and give patients a dynamic role in the decision-making approach. Prediction of single patient radiosensitivity before RT could prompt suggestion to entail a more and more tailored radiation treatment in the era of personalized approach.
Identifiants
pubmed: 34268681
doi: 10.1007/s11547-021-01395-z
pii: 10.1007/s11547-021-01395-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1366-1373Informations de copyright
© 2021. Italian Society of Medical Radiology.
Références
Darby S, McGale P, Correa C et al (2011) Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15- year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomized trials. Lancet. https://doi.org/10.1016/S0140-6736(11)61629-2
doi: 10.1016/S0140-6736(11)61629-2
pubmed: 22152853
Hopwood P, Haviland JS, Sumo G et al (2010) Comparison of patient-reported breast, arm, and shoulder symptoms and body image after radiotherapy for early breast cancer: 5-year follow-up in the randomised Standardisation of Breast Radiotherapy (START) trials. Lancet Oncol 11:231–240
doi: 10.1016/S1470-2045(09)70382-1
Williams LJ, Kunkler IH, King CC et al (2011) A randomised controlled trial of post-operative radiotherapy following breast-conserving surgery in a minimum-risk population. Quality of life at 5 years in the PRIME trial. Health Technol Assess. https://doi.org/10.3310/hta15120
doi: 10.3310/hta15120
pubmed: 22078311
pmcid: 4781007
Mukesh MB, Qian W, Wilkinson JS et al (2014) Patient reported outcome measures (PROMs) following forward planned field-in field IMRT: results of the Cambridge breast IMRT trial. Radiother Oncol 111:270–275
doi: 10.1016/j.radonc.2014.02.016
Talbot CJ, Tanteles GA, Barnett GC et al (2012) A replicated association between polymorphisms near TNFa and risk for adverse reactions to radiotherapy. Br J Cancer 107:748–753
doi: 10.1038/bjc.2012.290
Seibold P, Behrens S, Schmezer P et al (2015) XRCC1 polymorphism associated with late toxicity after radiation therapy in breast cancer patients. Int J Radiat Oncol Biol Phys 92:1084–1092
doi: 10.1016/j.ijrobp.2015.04.011
Andreassen CN, Rosenstein BS, Kerns SL et al (2016) Individual patient data metaanalysis shows a significant association between the ATM RS1801516 SNP and toxicity after radiotherapy in 5456 breast and prostate cancer patients. Radiother Oncol 121:431–439
doi: 10.1016/j.radonc.2016.06.017
Barnett GC, Thompson D, Fachal L et al (2014) A genome wide association study (GWAS) providing evidence of an association between common genetic variants and late radiotherapy toxicity. Radiother Oncol 111:178–185
doi: 10.1016/j.radonc.2014.02.012
Livi L, Meattini I, Scotti V et al (2011) Concomitant adjuvant chemo-radiation therapy with anthracyclinebased regimens in breast cancer: a single centre experience. Radiol med 116:1050–1058. https://doi.org/10.1007/s11547-011-0652-2
doi: 10.1007/s11547-011-0652-2
pubmed: 21424317
Reverberi C, Marinelli L, Campanella B et al (2020) Post-mastectomy immediate breast reconstruction and adjuvant radiotherapy: long term results of a mono institutional experience. Radiol med 125:887–893. https://doi.org/10.1007/s11547-020-01161-7
doi: 10.1007/s11547-020-01161-7
pubmed: 32166721
Barnett GC, Kerns SL, Noble DJ et al (2015) Incorporating genetic biomarkers into predictive models of normal tissue toxicity. Clin Oncol (R Coll Radiol) 27:579–587
doi: 10.1016/j.clon.2015.06.013
Kerns SL, de Ruysscher D, Andreassen CN et al (2014) STROGAR – strengthening the reporting of genetic association studies in radiogenomics. Radiother Oncol 110:182–188
doi: 10.1016/j.radonc.2013.07.011
Rancati T, Fiorino C, Fellin G et al (2011) Inclusion of clinical risk factors into NTCP modelling of late rectal toxicity after high dose radiotherapy for prostate cancer. Radiother Oncol 100:124–130
doi: 10.1016/j.radonc.2011.06.032
Franco P, De Rose F, De Santis MC et al (2020) Omission of postoperative radiation after breast conserving surgery: a progressive paradigm shift towards precision medicine. Clin Transl Radiat Oncol. https://doi.org/10.1016/j.ctro.2020.02.003
doi: 10.1016/j.ctro.2020.02.003
pubmed: 32632379
pmcid: 7299875
Seibold P, Webb A, Aguado-Barrera ME et al (2019) REQUITE: A prospective multicentre cohort study of patients undergoing radiotherapy for breast, lung or prostate cancer. Radiother Oncol 138:59–67. https://doi.org/10.1016/j.radonc.2019.04.034
doi: 10.1016/j.radonc.2019.04.034
pubmed: 31146072
Jamshed S (2014) Qualitative research method-interviewing and observation. J Basic Clin Pharm 5(4):87–88. https://doi.org/10.4103/0976-0105.141942
doi: 10.4103/0976-0105.141942
pubmed: 25316987
pmcid: 4194943
Rattay T, Symonds RP, Shokuhi S et al (2018) The patient perspective on radiogenomics testing for breast radiation toxicity. Clin Oncol (R Coll Radiol) 30(3):151–157. https://doi.org/10.1016/j.clon.2017.12.001
doi: 10.1016/j.clon.2017.12.001
Nold RJ, Beamer RL, Helmer SD et al (2000) Factors influencing a woman’s choice to undergo breast-conserving surgery versus modified radical mastectomy. Am J Surg 180(6):413–418. https://doi.org/10.1016/s0002-9610(00)00501-8
doi: 10.1016/s0002-9610(00)00501-8
pubmed: 11182389
Shaverdian N, Wang X, Hegde JV et al (2018) The patient’s perspective on breast radiotherapy: Initial fears and expectations versus reality. Cancer 124(8):1673–1681
doi: 10.1002/cncr.31159
Abul-Husn NS, Owusu Obeng A, Sanderson SC et al (2014) Implementation and utilization of genetic testing in personalized medicine. Pharmgenomics Pers Med 7:227–240
pubmed: 25206309
pmcid: 4157398
Sinding C, Hudak P, Wiernikowski J et al (2010) “I like to be an informed person but…” negotiating responsibility for treatment decisions in cancer care. Soc Sci Med. https://doi.org/10.1016/j.socscimed.2010.06.005
doi: 10.1016/j.socscimed.2010.06.005
pubmed: 20633970
Leech M, Katz MS, Kazmierska J et al (2020) Empowering patients in decision-making in radiation oncology - can we do better? Mol Oncol 14(7):1442–1460. https://doi.org/10.1002/1878-0261.12675
doi: 10.1002/1878-0261.12675
pubmed: 32198967
pmcid: 7332211
Menichetti J, Valdagni R, Bellardita L (2018) Quality of life in active surveillance and the associations with decision-making-a literature review. Transl Androl Urol 7(1):160–169. https://doi.org/10.21037/tau.2017.12.34
doi: 10.21037/tau.2017.12.34
pubmed: 29594030
pmcid: 5861287
National Collaborating Centre for Primary Care. Medicines adherence: involving patients in decisions about prescribed medicines and supporting adherence. (CG76). London: royal college of general practitioners; 2009. Available from: http://guidance.nice.org.uk/CG76 . (Guideline Ref ID NCCPC2009A)
Lawler M, Banks I, Law L et al (2016) The European Cancer Patient’s Bill of Rights, update and implementation 2016. ESMO Open 2017. https://doi.org/10.1136/esmoopen-2016-000127
doi: 10.1136/esmoopen-2016-000127
Manchikanti L, Caraway DL, Parr AT et al (2011) Patient Protection and Affordable Care Act of 2010: reforming the health care reform for the new decade. Pain Physician 14(1):E35–E67
doi: 10.36076/ppj.2011/14/E35
Salzburg Global Seminar (2011) Salzburg statement on shared decision making. BMJ, 342:d1745, https://doi.org/10.1136/bmj.d1745
Roberts JS, Gornick MC, Le LQ et al (2019) MI-ONCOSEQ Study team Next-generation sequencing in precision oncology: Patient understanding and expectations. Cancer Med 8(1):227–237
doi: 10.1002/cam4.1947
Fenton AT, Anderson EC, Scharnetzki E et al (2021) Differences in cancer patients’ and clinicians’ preferences for disclosure of uncertain genomic tumor testing result. Patient Educ Couns 104(1):3–11
doi: 10.1016/j.pec.2020.07.010
Bellardita L, Sobrero AI, Maiello E (2017) Processi decisionali nella pratica clinica del paziente con mCRC, Edra.