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Brief Title: Does the Use of a Genomic Tumor Board Increase the Number of Patients Who Receive Genome-Informed Treatment
Official Title: A Cluster Randomized Trial Comparing an Educationally Enhanced Genomic Tumor Board (EGTB) Intervention to Usual Practice to Increase Evidence-Based Genome-Informed Therapy
Study ID: NCT05455606
Brief Summary: This clinical trial studies how well an educationally enhanced genomic tumor board (EGTB) intervention works to increase the number of patients with solid tumors that have come back (recurrent), do not respond to treatment (refractory), have spread to other parts of the body (metastatic), or are newly diagnosed and spread to other parts of the body (advanced) who receive genome-informed treatment. Genome-informed treatment refers to treatment based on the information found in genomic tumor test results. This study compares the usual approach to reviewing genomic tumor test results with the approach of having a genomic tumor board (GTB) review the test results. A GTB is team of doctors and scientists that have experience in understanding genomic changes and review genomic tumor test results. The tumor board helps to suggest whether there are other cancer treatment options based on patient genetic test results. The usual approach is to review genomic tumor test results without the GTB being involved. This study may help researchers learn if using a GTB enhances the treatment decision making process within 6 months of joining the study. This study may also help researchers learn if using the GTB increases doctors' understanding of genomic tumor test results and increases doctors' comfort level with genomic tumor tests.
Detailed Description: PRIMARY OBJECTIVE: I. To determine whether an EGTB intervention compared to usual practice increases the proportion of patients who receive evidence-based genome-informed therapy within 6 months after registration to the study. SECONDARY OBJECTIVES: I. To compare physician genomic confidence and physician experience with genomic tumor testing (GTT) between arms at baseline and end of study. II. To compare clinical outcomes between arms by assessing patient survival and time to treatment discontinuation. III. To compare physician assessment of evidence-based genome-informed therapy to the central study team determination of evidence-based genome-informed therapy, both overall and separately by arm. IMPLEMENTATION OBJECTIVES: I. To assess the utilization of GTT and implementation of the EGTB intervention into clinic workflow in order to better understand barriers and facilitators at Recruitment Centers assigned to the active intervention arm using a mixed-methods approach. II. To assess the evolution of GTT utilization within clinic workflows at recruitment centers assigned to the usual practice (control) arm using a mixed-methods approach. OUTLINE: Study clinics are randomized to 1 of 2 arms. Participants receive interventions based on this randomization. ARM 1: Participants receive usual care. This consists of physicians ordering GTT for patients and reviewing the results without the GTB being involved. ARM 2: Patients and physicians receive the EGTB intervention. This is comprised of 2 components: the structured GTB and the supporting education. Physicians submit cases for discussion to the GTB within 2 weeks of GTT results. The GTB sessions are held weekly and conducted virtually over a video-conferencing platform. Each case presentation is 10 to 15 minutes long, and 4 to 6 cases are discussed during each 60 minute GTB session. GTT results and clinical data are presented and expert interpretation of genomic test results is provided to help prioritize potential treatment options and provide a framework for interpretation. Supporting education materials are also available online to participants to support GTT decision making. Physicians are followed until the end of the study or through 6 months after their last patient was registered to the study, whichever is later. Patients are followed for 24 months after registration or until a criterion for removal from protocol participation is met, whichever comes first.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Cancer Center at Saint Joseph's, Phoenix, Arizona, United States
Lewis Cancer and Research Pavilion at Saint Joseph's/Candler, Savannah, Georgia, United States
Hawaii Cancer Care - Westridge, 'Aiea, Hawaii, United States
Pali Momi Medical Center, 'Aiea, Hawaii, United States
Hawaii Cancer Care Inc - Waterfront Plaza, Honolulu, Hawaii, United States
Queen's Medical Center, Honolulu, Hawaii, United States
Straub Clinic and Hospital, Honolulu, Hawaii, United States
University of Hawaii Cancer Center, Honolulu, Hawaii, United States
Kapiolani Medical Center for Women and Children, Honolulu, Hawaii, United States
Kootenai Clinic Cancer Services - Post Falls, Post Falls, Idaho, United States
Illinois CancerCare-Bloomington, Bloomington, Illinois, United States
Illinois CancerCare-Canton, Canton, Illinois, United States
Carle at The Riverfront, Danville, Illinois, United States
Illinois CancerCare-Galesburg, Galesburg, Illinois, United States
Carle Physician Group-Mattoon/Charleston, Mattoon, Illinois, United States
Illinois CancerCare-Ottawa Clinic, Ottawa, Illinois, United States
Illinois CancerCare-Peoria, Peoria, Illinois, United States
Carle Cancer Center, Urbana, Illinois, United States
Iowa Methodist Medical Center, Des Moines, Iowa, United States
Medical Oncology and Hematology Associates-Des Moines, Des Moines, Iowa, United States
HaysMed University of Kansas Health System, Hays, Kansas, United States
Lawrence Memorial Hospital, Lawrence, Kansas, United States
Olathe Health Cancer Center, Olathe, Kansas, United States
University of Kansas Cancer Center-Overland Park, Overland Park, Kansas, United States
Salina Regional Health Center, Salina, Kansas, United States
University of Kansas Health System Saint Francis Campus, Topeka, Kansas, United States
Saint Joseph Hospital East, Lexington, Kentucky, United States
Saint Joseph London, London, Kentucky, United States
Saint Joseph Mercy Hospital, Ann Arbor, Michigan, United States
Saint Joseph Mercy Brighton, Brighton, Michigan, United States
Saint Joseph Mercy Chelsea, Chelsea, Michigan, United States
Ascension Saint John Hospital, Detroit, Michigan, United States
Trinity Health Saint Mary Mercy Livonia Hospital, Livonia, Michigan, United States
Saint Joseph Mercy Oakland, Pontiac, Michigan, United States
Essentia Health Saint Joseph's Medical Center, Brainerd, Minnesota, United States
Minnesota Oncology - Burnsville, Burnsville, Minnesota, United States
Mercy Hospital, Coon Rapids, Minnesota, United States
Essentia Health Cancer Center, Duluth, Minnesota, United States
Unity Hospital, Fridley, Minnesota, United States
Saint John's Hospital - Healtheast, Maplewood, Minnesota, United States
New Ulm Medical Center, New Ulm, Minnesota, United States
Park Nicollet Clinic - Saint Louis Park, Saint Louis Park, Minnesota, United States
Regions Hospital, Saint Paul, Minnesota, United States
Lakeview Hospital, Stillwater, Minnesota, United States
Ridgeview Medical Center, Waconia, Minnesota, United States
Minnesota Oncology Hematology PA-Woodbury, Woodbury, Minnesota, United States
Fairview Lakes Medical Center, Wyoming, Minnesota, United States
Parkland Health Center - Farmington, Farmington, Missouri, United States
Truman Medical Centers, Kansas City, Missouri, United States
University of Kansas Cancer Center - North, Kansas City, Missouri, United States
University of Kansas Cancer Center - Lee's Summit, Lee's Summit, Missouri, United States
University of Kansas Cancer Center at North Kansas City Hospital, North Kansas City, Missouri, United States
Delbert Day Cancer Institute at PCRMC, Rolla, Missouri, United States
Missouri Baptist Medical Center, Saint Louis, Missouri, United States
Sainte Genevieve County Memorial Hospital, Sainte Genevieve, Missouri, United States
CoxHealth South Hospital, Springfield, Missouri, United States
Missouri Baptist Sullivan Hospital, Sullivan, Missouri, United States
Missouri Baptist Outpatient Center-Sunset Hills, Sunset Hills, Missouri, United States
FirstHealth of the Carolinas-Moore Regional Hospital, Pinehurst, North Carolina, United States
Essentia Health Cancer Center-South University Clinic, Fargo, North Dakota, United States
Lehigh Valley Hospital-Cedar Crest, Allentown, Pennsylvania, United States
Saint Joseph's/Candler - Bluffton Campus, Bluffton, South Carolina, United States
Gibbs Cancer Center-Gaffney, Gaffney, South Carolina, United States
Gibbs Cancer Center-Pelham, Greer, South Carolina, United States
Spartanburg Medical Center, Spartanburg, South Carolina, United States
MGC Hematology Oncology-Union, Union, South Carolina, United States
Ascension Southeast Wisconsin Hospital - Elmbrook Campus, Brookfield, Wisconsin, United States
Ascension Saint Francis - Reiman Cancer Center, Franklin, Wisconsin, United States
Ascension Columbia Saint Mary's Hospital Ozaukee, Mequon, Wisconsin, United States
Ascension Medical Group Southeast Wisconsin - Mayfair Road, Wauwatosa, Wisconsin, United States
Doctors Cancer Center, Manati, , Puerto Rico
Centro Comprensivo de Cancer de UPR, San Juan, , Puerto Rico
Name: Jens Rueter
Affiliation: SWOG Cancer Research Network
Role: PRINCIPAL_INVESTIGATOR