Technology-Enhanced Acceleration of Germline Evaluation for Therapy, TARGET Study
Technology-Enhanced Acceleration of Germline Evaluation for Therapy - The TARGET Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. Perform user-testing of an education and patient history collection mobile tool among medical oncologists, radiation oncologists, and urologists across study practice settings, including Veterans Affairs to address genetic referral needs (n=10 providers). (Provider-focused) II. Develop multimedia web-based pretest genetic education (WBGE) tool and conduct a randomized trial of traditional genetic counseling (GC) (Arm 1) versus (vs.) WBGE (Arm 2) for informed and timely uptake of genetic testing for men with lethal/predicted lethal prostate cancer (PCA). (Patient-focused)
OUTLINE:
AIM I: Providers attend an interview over 1 hour to discuss how they would use the tool, then receive the tool to test in their clinic for 2 weeks. After 2 weeks, providers discuss their experience using the tool over 10-15 minutes. Providers have the option to use the tool for up to 6 months and complete a brief survey about the benefits and limitations of the tool for patient identification in Arm II.
AIM II: Patients are randomized to 1 of 2 arms.
ARM I (TRADITIONAL GENETIC COUNSELING): Patients receive genetic counseling with a certified genetic counselor in-person, by telehealth, or over the phone (according to patient preference). Patients may then undergo genetic testing.
ARM II (WEB-BASED GENETIC EDUCATION): Patients receive a link to the web-based genetic education tool online including all elements of genetic counseling in written modules and in a series of professional videos. Patients may then undergo genetic testing. Patients may cross-over to Arm I to see a genetic counselor.
After the completion of study, patients are followed up yearly for up to 5 years.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
New York
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New York, New York, United States, 10010
- VA New York Harbor Health System- Manhattan Campus
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New York, New York, United States, 10016
- New York University- Langone Health
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Syracuse, New York, United States, 13210
- Associated Medical Professions of New York
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19107
- Sidney Kimmel Cancer Center at Thomas Jefferson University
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Washington
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Seattle, Washington, United States, 98109
- University of Washington/ SCCA
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria
- AIM 1: Medical oncologists, radiation oncologists and urologists spanning Veterans Affairs (VA), academic, and community settings
AIM 2: Any English speaking man >= 18 with PCA who has computer and web-access and meets any one of the following:
- Metastatic disease
- T3a or higher
- Prostate specific antigen (PSA) > 20
- Grade group 4 or higher
- Intraductal or cribriform histology
- Biochemical recurrence
- Ashkenazi Jewish ancestry
Family history criteria (see below) ** Family history: If any one of the following levels are met, the person is eligible:
- Level 1: >= 1 close blood relative (first degree relative [FDR], second degree relative [SDR], third degree relative [TDR]) diagnosed with breast cancer =< age 50 or the following cancers at any age: pancreatic, ovarian, or metastatic or intraductal/cribriform prostate cancer
- Level 2: >= 2 close blood relatives (FDR, SDR, TDR) on same side of the family with breast or prostate cancer at any age
- Level 3: one brother, father, or >= 2 family members (close blood relatives - FDR, SDR, TDR) on the same side of the family diagnosed with prostate cancer at < 60
- Level 4: >= 3 cancers on the same side of the family (especially if diagnosed =< 50): bile duct, breast, colorectal, endometrial, gastric, kidney, melanoma, ovarian, pancreatic, prostate (grade groups 2-5 if known), small bowel, or urothelial
Exclusion Criteria
- Age < 18 years
- Mental or cognitive impairment that interferes with ability to provide informed consent
- Non-English speaking
- Having had prior germline genetic testing for inherited cancer risk (pertains to aim 2)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Aim I (Interview)
Providers attend an interview over 1 hour to discuss how they would use the tool, then receive the tool to test in their clinic for 2 weeks.
After 2 weeks, providers discuss their experience using the tool over 10-15 minutes.
Providers have the option to use the tool for up to 6 months and complete a brief survey about the benefits and limitations of the tool for patient identification in Arm II.
|
Attend Interview
Use web-based genetic education tool online
Ancillary Studies
|
|
Active Comparator: Aim II: Arm I (Genetic Counseling, Genetic Testing)
Patients receive genetic counseling with a certified genetic counselor in-person, by telehealth, or over the phone (according to patient preference).
Patients may then undergo genetic testing.
|
Ancillary Studies
Receive in-person, telehealth, or over-the-phone genetic counseling
Undergo genetic testing
Other Names:
|
|
Experimental: Aim II: Arm II (WBGE, Genetic Couseling, Genetic Testing)
Patients receive a link to the web-based genetic education tool online including all elements of genetic counseling in written modules and in a series of professional videos.
Patient may then undergo genetic testing.
Patient may cross-over to Arm I to see a genetic counselor.
|
Ancillary Studies
Receive in-person, telehealth, or over-the-phone genetic counseling
Undergo genetic testing
Other Names:
Use web-based genetic education tool online
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
User Testing of the Provider Tool - (Aim I)
Time Frame: Up to 6 months
|
Provider perspectives will include: (1) whether the target population can use the tool in the way it was intended (i.e., to perform patient history collection to determine consideration for germline testing), and (2) interaction with this tool affects the user's cognitive representation of genetic testing for prostate cancer (PCA).
To evaluate the first point, will collect initial information from participants regarding their experience with the guidelines for genetic testing and how they collect data on family history.
Will evaluate participants' mental model for germline testing and how they identify suitable candidates before interaction with the tool.
Will use a cognitive concept mapping technique, which can be used to formalize a person's cognitive representation for complex topics.
Feedback from this testing will be used to iteratively refine the tool while it is being used by providers to identify patients randomized trial in Aim II.
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Up to 6 months
|
|
Decisional Conflict (Aim II)
Time Frame: Up to 6 months
|
Will be assessed for non-inferiority between study arms.
Evaluated using the O'Connor decisional conflict scale, which captures sub-scores over 16-questions for uncertainty, feeling of being informed, values clarity, support, and effective decision making on a 5-point Likert scale
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Up to 6 months
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Cancer Genetics Knowledge (Aim II)
Time Frame: Up to 6 Months
|
Assessed using pre- and post-intervention surveys.
Cancer genetics knowledge will be adapted from Erblich.
et al (2005) for relevance to PCA genetics (23 True/False questions) (Cronbach's alpha = 0.92).
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Up to 6 Months
|
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Genetic Testing Uptake (Aim II)
Time Frame: Up to 5 years
|
Assessed using pre-and post-intervention surveys
|
Up to 5 years
|
|
Satisfaction with Genetic Counseling or Web-Based Genetic Education (Aim II)
Time Frame: After viewing the web tool
|
Will capture men's satisfaction with each arm using the Satisfaction with Genetic Counseling Scale at the end of pre-test genetic counseling or after viewing the web tool.
This 6-item scale includes questions such as: "My genetic counselor seemed to understand the stresses I was facing," and "The genetic counseling session was valuable to me" rated on a 5-point Likert scale (Cronbach's alpha 0.7-0.88).
The questions will be adapted for web-based pretest genetic education such as "This webtool addressed all of the concerns I had" or "The webtool was valuable to me".
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After viewing the web tool
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Understanding of personal genetic test results (Aim II)
Time Frame: Up to 5 years
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Assessed using pre- and post-intervention surveys.
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Up to 5 years
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Sharing of genetic information with families (Aim II)
Time Frame: Up to 5 years
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Assessed using pre- and post-intervention surveys.
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Up to 5 years
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Literacy (Aim II)
Time Frame: Up to 5 years
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Assessed using pre- and post-intervention surveys.
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Up to 5 years
|
|
Numeracy (Aim II)
Time Frame: Up to 5 years
|
Assessed using pre- and post-intervention surveys.
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Up to 5 years
|
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Diet (Aim II)
Time Frame: Up to 5 years
|
Assessed using pre- and post-intervention surveys.
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Up to 5 years
|
|
Physical activity (Aim II)
Time Frame: Up to 5 years
|
Assessed using pre- and post-intervention surveys.
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Up to 5 years
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Veda Giri, MD, Clinical Cancer Genetics Yale School of Medicine
- Principal Investigator: Stacy Loeb, MD, MSc, NYU- Langone Health, Manhattan VA Hospital
Publications and helpful links
General Publications
- Loeb S, Cheng HH, Leader A, Gross L, Nolasco TS, Byrne N, Wise DR, Hollifield L, Brown LH, Slater E, Pieczonka C, Gomella LG, Kelly WK, Trabulsi EJ, Handley N, Lallas CD, Chandrasekar T, Mille P, Mann M, Mark JR, Brown G, Chopra S, Wasserman J, Phillips J, Somers P, Giri VN. Technology-enhanced AcceleRation of Germline Evaluation for Therapy (TARGET): A randomized controlled trial of a pretest patient-driven webtool vs. genetic counseling for prostate cancer germline testing. Contemp Clin Trials. 2022 Aug;119:106821. doi: 10.1016/j.cct.2022.106821. Epub 2022 Jun 14.
- Loeb S, Keith SW, Cheng HH, Leader AE, Gross L, Sanchez Nolasco T, Byrne N, Hartman R, Brown LH, Pieczonka CM, Gomella LG, Kelly WK, Lallas CD, Handley N, Mille PJ, Mark JR, Brown GA, Chopra S, McClellan A, Wise DR, Hollifield L, Giri VN. TARGET: A Randomized, Noninferiority Trial of a Pretest, Patient-Driven Genetic Education Webtool Versus Genetic Counseling for Prostate Cancer Germline Testing. JCO Precis Oncol. 2024 Mar;8:e2300552. doi: 10.1200/PO.23.00552.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Urogenital Diseases
- Genital Diseases
- Genital Neoplasms, Male
- Urogenital Neoplasms
- Neoplasms by Site
- Neoplasms
- Genital Diseases, Male
- Prostatic Diseases
- Male Urogenital Diseases
- Prostatic Neoplasms
- Health Care Quality, Access, and Evaluation
- Investigative Techniques
- Epidemiologic Methods
- Clinical Laboratory Techniques
- Diagnostic Techniques and Procedures
- Diagnosis
- Data Collection
- Health Care Evaluation Mechanisms
- Quality of Health Care
- Public Health
- Environment and Public Health
- Health Services
- Health Care Facilities Workforce and Services
- Preventive Health Services
- Genetic Techniques
- Genetic Services
- Diagnostic Services
- Interviews as Topic
- Genetic Testing
- Genetic Counseling
Other Study ID Numbers
Other Study ID Numbers
- 20G.013
- 19CHAL05 (Other Grant/Funding Number: Prostate Cancer Foundation)
- JT 14902 (Other Identifier: JeffTrial Number)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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