Understanding Physicians’ Decision-Making Practices Related to Biomarker Testing: Analysis of the Adelphi Real-World Ovarian Cancer II Disease Specific Programme (DSPTM)

OBJECTIVES: Although biomarker testing in patients with advanced ovarian cancer (aOC) informs treatment options, direct insights on the frequency of and motivation for testing are limited. Improving biomarker-testing education may encourage testing implementation and treatment optimization. This study describes biomarker-testing practices in a real-world setting.

METHODS: The 2023 Adelphi Real World OC II DSP™ is a cross-sectional survey of physicians treating aOC. Participating countries include Canada, the United States (US), and France, Germany, Spain, and the United Kingdom (EU4). Data collection is ongoing, with interim results reported for 140 physicians actively involved in prescribing decisions for patients with aOC and who completed a detailed survey describing biomarker-testing patterns. Analyses were descriptive.

RESULTS: Most physicians reported homologous recombination deficiency (HRD; 92%) and BRCA (86%) testing of their patients with aOC. 70% of completed BRCA tests were done as part of HRD testing. 55% of patients were tested for HRD at diagnosis; 36%, 24%, 15% and 10% were tested before first-line (1L) treatment initiation, during 1L, after 1L and during second-line treatment or later, respectively. Most physicians (84%) reported using HRD status to support their decision-making for maintenance therapy use, whereas 36% and 31% reported that it informs their decision for the use of chemotherapy and understanding the likelihood of disease progression, respectively. Retesting for HRD status was conducted by 27% of physicians, most commonly in the US (50%). Of physicians who ordered retesting, 71% did so after progression on 1L treatment. More than half of physicians (59%) anticipate increased HRD testing in the next 2–3 years.

CONCLUSIONS: Physicians treating aOC frequently used HRD and BRCA testing in the US and EU4, most commonly at diagnosis, to support maintenance therapy decisions. As treatments evolve, continued biomarker-testing education and implementation will be needed to ensure treatment optimization.