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Fawcett LK, Wakefield CE, Sivam S, Middleton PG, Wark P, Widger J, Jaffe A, Waters SA. Avatar acceptability: views from the Australian Cystic Fibrosis community on the use of personalised organoid technology to guide treatment decisions. ERJ Open Res 2021; 7:00448-2020. [PMID: 33532470 PMCID: PMC7836586 DOI: 10.1183/23120541.00448-2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/18/2020] [Indexed: 12/22/2022] Open
Abstract
Background Patient-oriented research approaches that reflect the needs and priorities of those most affected by health research outcomes improves translation of research findings into practice. Targeted therapies for cystic fibrosis (CF) are now a viable treatment option for some eligible individuals despite the heterogeneous patient-specific therapeutic response. This has necessitated development of a clinical tool that predicts treatment response for individual patients. Patient-derived mini-organs (organoids) have been at the forefront of this development. However, little is known about their acceptability in CF patients and members of the public. Methods We used a cross-sectional observational design to conduct an online survey in people with CF, their carers and community comparisons. Acceptability was examined in five domains: 1) willingness to use organoids, 2) perceived advantages and disadvantages of organoids, 3) acceptable out-of-pocket costs, 4) turnaround time and 5) source of tissue. Results In total, 188 participants completed the questionnaire, including adults with CF and parents of children with CF (90 (48%)), and adults without CF and parents of children without CF (98 (52%)). Use of organoids to guide treatment decisions in CF was acceptable to 86 (95%) CF participants and 98 (100%) community participants. The most important advantage was that organoids may improve treatment selection, improving the patient's quality of life and life expectancy. The most important disadvantage was that the organoid recommended treatment might be unavailable or too expensive. Conclusions These findings indicate acceptance of patient-derived organoids as a tool to predict treatment response by the majority of people surveyed. This may indicate successful future implementation into healthcare systems. The perspective regarding clinical use of patient-derived organoid models to enable cystic fibrosis personalised therapeutic decision-making of 188 participating adults surveyedhttps://bit.ly/30nWDJ7
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Affiliation(s)
- Laura K Fawcett
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.,Molecular and Integrative Cystic Fibrosis Research Centre, University of New South Wales, Sydney and Sydney Children's Hospital, Sydney, NSW, Australia.,Dept of Respiratory Medicine, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Claire E Wakefield
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Sheila Sivam
- Dept of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Peter G Middleton
- Cystic Fibrosis Unit, Dept of Respiratory and Sleep Medicine, Westmead Hospital, Sydney, NSW, Australia
| | - Peter Wark
- Centre for Healthy Lungs, University of Newcastle, Newcastle, NSW, Australia
| | - John Widger
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.,Molecular and Integrative Cystic Fibrosis Research Centre, University of New South Wales, Sydney and Sydney Children's Hospital, Sydney, NSW, Australia.,Dept of Respiratory Medicine, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Adam Jaffe
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.,Molecular and Integrative Cystic Fibrosis Research Centre, University of New South Wales, Sydney and Sydney Children's Hospital, Sydney, NSW, Australia.,Dept of Respiratory Medicine, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Shafagh A Waters
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.,Molecular and Integrative Cystic Fibrosis Research Centre, University of New South Wales, Sydney and Sydney Children's Hospital, Sydney, NSW, Australia.,Dept of Respiratory Medicine, Sydney Children's Hospital, Sydney, NSW, Australia
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Wakefield CE, Doolan EL, Fardell JE, Signorelli C, Quinn VF, Tucker KM, Patenaude AF, Marshall GM, Lock RB, Georgiou G, Cohn RJ. The Avatar Acceptability Study: Survivor, Parent and Community Willingness to Use Patient-Derived Xenografts to Personalize Cancer Care. EBioMedicine 2018; 37:205-213. [PMID: 30385234 PMCID: PMC6286267 DOI: 10.1016/j.ebiom.2018.10.060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 10/22/2018] [Accepted: 10/24/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Using patient-derived xenografts (PDXs) to assess chemosensitivity to anti-cancer agents in real-time may improve cancer care by enabling individualized clinical decision-making. However, it is unknown whether this new approach will be met with acceptance by patients, family and community. METHODS We used a cross-sectional structured survey to investigate PDX acceptability with 1550 individuals across Australia and New Zealand (648 survivors of adult and childhood cancer, versus 650 community comparisons; and 48 parents of childhood cancer survivors versus 204 community parents). We identified factors influencing willingness-to-use PDXs, willingness-to-pay, maximum acceptable wait-time, and maximum acceptable number of mice used per patient. FINDINGS PDXs were highly acceptable: >80% of those affected by cancer felt the potential advantages of PDXs outweighed the disadvantages (community participants: 68%). Survivors' and survivors' parents' most highly endorsed advantage was 'increased chance of survival'. 'Harm to animals' was the least endorsed disadvantage for all groups. Cancer survivors were more willing to use PDXs than community comparisons [p < ·001]. Survivors and survivors' parents were willing to pay more [p < ·001; p = ∙004 respectively], wait longer for results [p = ·03; p = ∙01], and use more mice [p = ·01; p < ∙001] than community comparisons. Male survivors found PDXs more acceptable [p = ·01] and were willing to pay more [p < ·001] than female survivors. Survivors with higher incomes found PDXs more acceptable [p = ·002] and were willing to pay more [p < ·001] than survivors with lower incomes. Mothers found PDXs more acceptable [p = ·04] but were less willing to wait [p = ·02] than fathers. INTERPRETATION We found significant attitudinal support for PDX-guided cancer care. Willingness-to-pay and maximum acceptable number of mice align well with likely future usage. Maximum acceptable wait-times were lower than is currently achievable, highlighting an important area for future patient education until technology has caught up.
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Affiliation(s)
- C E Wakefield
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, UNSW, Sydney, NSW, Australia.
| | - E L Doolan
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, UNSW, Sydney, NSW, Australia
| | - J E Fardell
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, UNSW, Sydney, NSW, Australia
| | - C Signorelli
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, UNSW, Sydney, NSW, Australia
| | - V F Quinn
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, UNSW, Sydney, NSW, Australia
| | - K M Tucker
- Hereditary Cancer Clinic, Department of Medical Oncology, Prince of Wales Hospital, NSW, Australia.; Prince of Wales Clinical School, Faculty of Medicine, Prince of Wales Hospital, NSW, Australia
| | - A F Patenaude
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - G M Marshall
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, UNSW, Sydney, NSW, Australia; Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia
| | - R B Lock
- School of Women's and Children's Health, UNSW, Sydney, NSW, Australia; Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia
| | - G Georgiou
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, UNSW, Sydney, NSW, Australia
| | - R J Cohn
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia; School of Women's and Children's Health, UNSW, Sydney, NSW, Australia
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