By Lori Solomon, Editor, Diagnostic Testing & Emerging Technologies
Online marketing of personalized cancer tests and services frequently overemphasize their reported benefits, neglect to disclose their limitations, and promote genetic tests that do not have demonstrated clinical utility, according to a study published March 5 in the Journal of the National Cancer Institute.
“While somatic and germline testing stands to dramatically improve patient outcomes, the paucity of genetic testing regulation may undermine high-quality cancer care if unproven products are promoted,” write the authors led by Stacy Gray, M.D., from the Dana-Farber Cancer Institute (Boston). “Few data describe the uptake of online personalized cancer medicine products, several examples provide evidence that demand may be substantial.”
Gray and colleagues conducted a systematic analysis of Internet websites to assess personalized cancer medicine (PCM) products and claims. PCM tests and services were defined broadly and included both genomic and tumor-derived data. Sites were identified through the top 30 websites on Google, Yahoo, and Bing, using 54 search terms related to personalized or genomic cancer care, as well as websites identified through a literature review and an abstraction of exhibitor information from a national oncology conference. Researchers categorized each PCM as standard or nonstandard based on evidence of clinical utility.
Ultimately, 55 websites were identified that marketed PCM products online, somatic (58 percent) and germline (20 percent). The majority of websites were sponsored by a commercial entity (56 percent), but academic institutions (20 percent), private institutions (15 percent), and individual physicians (2 percent) sponsored other sites. Marketed products included interpretive services (15 percent) and physicians/institutions offering personalized care (44 percent). Of 32 sites offering somatic analysis, 56 percent included specific test information.
The researchers found that significantly more websites contained information about the benefits of PCM versus limitations of PCM (85 percent versus 27 percent). Some of the marketing claims included tailoring therapy, outcome benefits, identifying clinical trials, decreasing side effects, cost savings, and psychological benefits.
Some websites marketed guideline-endorsed tests such as EGFR and BRAF (28 percent of sites), but 88 percent percent of sites marketing somatic analysis promoted one or more nonstandard tests (lacking evidence of clinical utility).
While the uptake of these products and services resulting from online marketing is uncertain, 29 percent of commercial sites provided guidance to patients about discussing PCM products with their physician and 10 percent included a directory of physicians who could provide the specific test or service. Cost of testing was included in roughly half of the commercial websites, with test prices ranging from $99 to $13,000. The authors suggest future work needs to address the downstream financial and medical impact of these PCMs.
“While such marketing may help to disseminate information about evidence-based tests, most companies also market tests that have little or no evidence substantiating the ability to improve patient outcomes,” conclude the authors. “Given the lack of uniform regulation over Internet marketing, disproportionate claims of benefit, and promotion of nonstandard technologies, it is essential that clinicians and patients critically evaluate online products.”