Comprehensive genomic profiling (CGP) of cancer tissue is increasingly being used to guide personalised treatments, yet concern remains high regarding patient responses to actionable and non-actionable findings.
Guided by Uncertainty Theory and Social Cognitive Theory, this study aimed to explore psychological responses in advanced cancer patients who have recently received actionable and non-actionable CGP results, and factors associated with these responses.
Participants in the Psychosocial Issues in Genomics in Oncology (PiGeOn) project, a longitudinal, psychosocial sub-study of the Molecular Screening and Therapeutics (MoST) Program, completed questionnaires at T0 (baseline, just prior to testing) and after receiving CGP results (T1).
1422 (94%) participants completed the T0 questionnaire, of which 1191 received results and 560 (47%) completed the T1 questionnaire. Patients who received actionable results (n=356, 64%) had lower Multidimensional Impact of Cancer Risk Assessment (p< 0.001) and Impact of Events scores (p = 0.039) and higher Satisfaction with Decision scores (p = 0.04) than patients with non-actionable results (n=204, 36%). Of patients who received actionable results, those who were offered treatment within the MoST Program (n=151) reported lower anxiety (p = 0.002) and depression (p = 0.01) and higher hope (p = 0.002) than those offered CGP-guided treatment through their oncologist (n=205). Patients with more positive attitudes towards uncertainty and higher self-efficacy for coping with results reported lower levels of psychological distress and uncertainty, and higher hope and satisfaction with the decision to have CGP. Additionally, those with higher knowledge reported greater anxiety.
Patients with advanced cancer who receive an actionable result experience less distress than those who do not. Access to treatment through the MoST program for those with actionable results is associated with less distress than in a non-research setting. Addressing attitudes towards uncertainty and self-efficacy may assist patients to cope with results.