Rapid Fire Best of the Best Poster Oral Clinical Oncology Society of Australia Annual Scientific Meeting 2021

Psychological outcomes in advanced cancer patients after receiving genomic tumour profiling results (#391)

Sabina Vatter 1 , Timothy E Schlub 2 , Christine E Napier 3 , Megan C Best 4 , Nicci Bartley 1 , Ilona Juraskova 5 , Bettina Meiser 6 , Mandy L Ballinger 3 7 , Barbara B Biesecker 8 , David Goldstein 9 , David M Thomas 3 7 , Phyllis Butow 1
  1. Faculty of Science/Psycho-oncology Co-Operative Research Group (PoCoG), University of Sydney, Camperdown, NSW, Australia
  2. Faculty of Medicine and Health, Sydney School of Public Health, Sydney Health Ethics, University of Sydney, Camperdown, NSW, Australia
  3. Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
  4. Institute for Ethics and Society, University of Notre Dame Australia, Sydney, New South Wales, Australia
  5. Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), University of Sydney, Camperdown, NSW, Australia
  6. Psychosocial Research Group, Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
  7. St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
  8. Newborn Screening, Ethics and Disability Studies, RTI International, Washington, DC, USA
  9. Department of Medical Oncology, Prince of Wales Hospital, Sydney, New South Wales, Australia

Background: Comprehensive tumour genomic profiling (CGP) offers hope for personalised treatment for cancer patients when other treatment options have been exhausted. However, receipt of nonactionable or ambiguous results could be an ongoing source of distress. We investigated patterns of hope, anxiety, depression and CGP-specific anxiety in advanced cancer patients after receiving CGP results and 2-3 months later.

Methods: Participants were enrolled in a longitudinal psychosocial sub-study, embedded in the Molecular Screening and Therapeutics Program, and had advanced solid cancers of any histological type with sufficient and accessible tissue for CGP. At T0 (before CGP testing), 1431 participants completed sociodemographic, disease and psychosocial measures. At T1 (1-4 weeks after receiving CGP results) and T2 (2-3 months post-T1), 374 participants completed psychological outcome measures. Predictors of outcomes at T2 were identified using multinomial logistic regression.

Results: Approximately 75% of participants did not experience significant hopelessness or distress at T1 and T2. Hope decreased by T2, yet general anxiety and CGP-specific anxiety also decreased. Receiving actionable results did not impact psychological outcomes at T2. At T2, lower hope, and higher anxiety, depression and CGP-specific anxiety were associated with lower self-efficacy. Psychological and demographic factors (age, socioeconomic status, language, medical occupation, urban living, family history of cancer) independently predicted one or more psychological trajectories. Worse health status and perceived susceptibility to cancer progression predicted hope and anxiety trajectories.

Conclusion: Counselling should be offered to patients with high anxiety, hopelessness, fear of cancer progression and poorer health to support psychological well-being when undergoing CGP.