EP361/#717 Developing infrastructure for molecular profiling in ovarian cancer (DEMO)

Abstract

Objectives Poor patient understanding and biopsy quality could both reduce the number of successful molecular tests performed after the diagnosis of ovarian cancer. DEMO is a multi-centre quality improvement study that aims to improve the uptake and success rates of tumoural and germline molecular testing in ovarian cancer. The two lead sites that have vastly different patient demographics. One in 7 (15%) women diagnosed in Birmingham are non-Caucasian with high number of patients requiring interpreters for their consultations, whilst patients diagnosed in Cambridge are mostly Caucasian and fluent in English. Methods The three components of DEMO include 1) the establishment of a patient advisory group to co-produce a multimedia, multilingual patient information package to support informed decision making, 2) the use of improvement methodology to analyse existing diagnostic pathways and 3) the development of a multidisciplinary consensus guideline to improve the current biopsy pathways for molecular profiling. Results The first retrospective audit (n=75; January-August 2021) demonstrated high tumoural (BRCA or Homologous Repair Deficiency) testing failure rates of 25% (3/12) and 35% (11/31) of samples from image-guided biopsies and postchemotherapy resections, respectively. A prospective audit pathway has been agreed to inform future practice. In addition, the first patients advisory group discussion in June 2022 will provide a qualitative narrative on patients' perceptions on molecular testing and explore how patients would like such complex information conveyed to support patient information package development. Conclusions Supporting informed decision making for all and establish auditable pathways are crucial for the implementation of molecular profiling to improve ovarian cancer care.