Background: Our understanding of cancer genome, driver mutations and impact of targeted therapies on patient outcomes has given a new perspective to cancer management often referred to as personalised cancer medicine (PCM). While this provides hope for delivering the right treatment for the right patient, it also raises questions on incremental health costs and sustainability. Patient preferences play an important role in treatment decisions and an understanding of PCM may heavily impact these decisions.

Method: This is a qualitative study that utilises open-ended interviews to capture patient understanding of PCM in treating advanced lung cancer. The intended sample size is 10. The inclusion criteria for participants are diagnosis of advanced lung cancer and eligibility to receive systemic therapy. Interview duration is approximately 60 minutes using an open-ended biographical structure to capture insights on, treatment history, physician engagement, perception of PCM and consequent trade-offs. Interviews are audio-recorded and transcribed, with results analysed thematically in an iterative process.

Results: Participants interviewed to date were diagnosed within the last two years, had previously been treated with chemotherapy and more recently received a targeted or personalised care therapy. Each had undergone genetic testing to determine suitability for PCM. Thematic content analysis revealed a strong relationship between positive physician interactions, offers of personalised treatment and willingness to pay. The perceived benefits of PCM, such as improved quality of life, reduced tumour burden, progression free survival, underpin willingness to pay. There is considerable willingness to seek out information on alternate treatments, which in some cases lead to PCM awareness. All participants were strongly affected by their interaction with the oncologist, with key modulators of treatment decisions for the patient being preserved quality of life and improved life expectancy.

Conclusion: These results have strong implications on our understanding of patient needs and expectations while undergoing treatment for advanced cancer. A prospective quantitative study in a larger patient cohort can help further answer the trade-offs and the decision making process applied to access PCM.