Abstract P2-12-21: A Video Intervention to Improve Patient Understanding of Tumor Genomic Testing in Patients with Metastatic Breast Cancer: Primary Results of a Prospective Intervention Trial

Abstract Background: Tumor genomic testing (TGT) has become standard-of-care for all patients with metastatic breast cancer (MBC). Guidelines for patient education prior to TGT from the American Society of Clinical Oncology (ASCO) and the American College of Medical Genetics (ACMG) are not widely followed. We have previously demonstrated disparities in general genomic knowledge across race and income. The purpose of this study was to evaluate the impact of a concise (3-4 minute) video for patient education prior to TGT in a prospective interventional trial. We report the results of the MBC cohort (ClinicalTrials.gov NCT05215769). Methods: We created a base animated video incorporating culturally diverse images, available in English and Spanish, applicable to any cancer type, with MBC-specific content included for patients with MBC. From March 2022 to June 2024, a total of 54 patients with MBC were enrolled at a single tertiary academic institution, and three community cancer centers. Participants completed validated survey instruments immediately prior to video viewing (T1), immediately post-viewing (T2) and after receipt of their own TGT results (T3). Instruments included: 1) 10-question objective genomic knowledge/understanding (GKU); 2) 10-question video message-specific knowledge/recall (VMSK); 3) 11-question Trust in Physician/Provider (TIPP); 4) attitudes around TGT. The primary objective was to assess change in VMSK between T1 and T2. A cohort of fifty patients provided 90% power to detect an effect size of 0.47 in change of recall accuracy from pre- to post-video using two-sided Wilcoxon signed-rank test with alpha of 0.05. The associations of VMSK, GKU, and TIPP with categorical demographic variables were explored with Kruskal-Wallis test. Results: To date 50 of the 54 patients with MBC enrolled have completed surveys at all timepoints. The MBC cohort had a median age of 57; all were female; most were Caucasian (49/54, 91%); most were married/in domestic partnership (41/54, 76%). For the primary endpoint, there was a significant increase in VMSK (p<0.001) but there was no significant change in GKU (p=0.89) or TIPP (p=0.59). Improvement of VMSK was consistent across demographic groups, including race/ethnicity, age, income, and education. Of the 10-questions in the VMSK survey, results for four questions significantly improved after viewing the video, including questions informing the likelihood of TGT impact on treatment decision, incidental germline findings, and cost of testing. However, the improvement seen was not consistently sustained at T3 in seven of ten questions. Higher baseline genomic knowledge was significantly associated with higher participant income. Conclusions: A single viewing of our concise, 3-4 minute, broadly applicable video incorporating culturally diverse images administered prior to TGT significantly improved VMSK across all demographic groups. While video content recall regressed over time, patient’s perception of the merits of TGT and their TIPP remained unchanged. This approach can be a valuable tool for empowering patients and educating them on the risks, benefits, and limitations of TGT in alignment with ASCO and ACMG guidelines. Citation Format: Deloris Veney, Lai Wei, Amanda E. Toland, Carolyn J. Presley, Tasleem J. Padamsee, Clara N. Lee, Heather Hampel, William J. Irvin, James Kim, Michael J. Bishop, Shelly R. Hovick, Leigha Senter, Daniel G. Stover. A Video Intervention to Improve Patient Understanding of Tumor Genomic Testing in Patients with Metastatic Breast Cancer: Primary Results of a Prospective Intervention Trial [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P2-12-21.