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2022-RA-1058-ESGO Developing infrastructure for molecular profiling for all in ovarian cancer (DEMO)
  1. Elaine Leung1,2,
  2. Gabriel Funingana3,
  3. Lisa Bird4,
  4. Marie-Lyne Alcaraz3,
  5. Joo Ern Ang5,
  6. Christine Parkinson5,
  7. Merche Jimenez-Linan5,
  8. Sue Freeman5,
  9. Catherine Spencer2,
  10. Julie Winning6,
  11. Raji Ganesan7,
  12. Sarah Williams6,
  13. Kai Ren Ong6,
  14. Parveen Abedin7,
  15. William Boyle7,
  16. Sudha Sundar2,
  17. Janos Balega2 and
  18. James Brenton3
  1. 1Institute of Cancer and Genomics Sciences, University of Birmingham, Birmingham, UK
  2. 2Pan-Birmingham Gynaecological Cancer Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK
  3. 3CRUK Cambridge Centre, University of Cambridge, Cambridge, UK
  4. 4University of Birmingham, Birmingham, UK
  5. 5Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  6. 6University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  7. 7Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK


Introduction/Background The lack of patient engagement 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 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.

Methodology 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

3) the development of a multidisciplinary consensus guideline to improve the current biopsy pathways for molecular profiling.

Results Our initial 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 post-chemotherapy resections, respectively. A prospective audit pathway has been agreed to inform future practice.In addition, the first patients advisory group discussion in June 2022 has provided 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.

Abstract 2022-RA-1058-ESGO Figure 1

Conclusion Supporting informed decision making for all and establish auditable biopsy pathways are crucial for the implementation of molecular profiling to improve ovarian cancer care.

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