The Importance of Patient Education and Individualized GI Cancer Care

Providing patient education alongside individualized navigation can improve genomic testing uptake and downstream participation in genomics-based clinical trials, according to data from the SURGE study, which were shared at the 2026 ASCO Gastrointestinal Cancers Symposium.

At the meeting, Dr. Nadine A Jackson, principal investigator of the research, also emphasized that research is ongoing and will aim to demonstrate that patient education is feasible and that navigation contributes additional support in oncology.

“We presented data showing that by educating patients using a video, which is a quite simple tool concordant with their primary language (it was provided in seven different languages) and also providing a navigator for a subset of patients, most of our patients were able to consent to genomic testing. This navigator is someone who is at their elbow, available to assist them, to answer questions about genomic testing, and also to coach them once those results are available on how to discuss those findings with their doctor and the opportunities those findings create for clinical trials,” Jackson emphasized in an exclusive interview with CURE.

Read through the entire interview with Jackson, a senior physician at Dana-Farber Cancer Institute and associate professor of medicine at Harvard Medical School, here!

Background and Rationale of the SURGE Trial

Disparities persist in cancer clinical trial enrollment, particularly among patients from historically underrepresented backgrounds. These gaps limit access to therapies and can contribute to poorer cancer outcomes. Although many modern cancer trials rely on genomic testing to determine eligibility, few studies have examined whether low awareness of genomic testing and limited readiness to pursue testing play a role in these disparities.

“The SURGE study stands for Supporting Utility and Representation in Genomics Clinical Trial Enrollment. The reason we have this study is because a lot of patients don't know that the way we make decisions nowadays about cancer treatment is based on finding these unique features in your tumor; a lot of our trials, over 70%, are based on those unique findings,” Jackson told CURE.

Investigators evaluated whether patient-centered tools, including video-based education and personalized navigation, could increase genomic testing utilization and, in turn, improve representation in genomics-based clinical trials.

How the SURGE Study Was Designed

SURGE enrolled adults older than 18 years with suspected or confirmed advanced malignancies who were new patients planning to continue care at Dana-Farber Cancer Institute. Participants were randomly assigned to one of three groups: usual care; video-based education focused on genomic testing and clinical trials; or a combination of video-based education plus patient navigation for six months.

Researchers assessed outcomes using questionnaires administered before and after the intervention to measure awareness of and readiness for genomic testing and clinical trial participation. Additional end points included consent and completion rates for genomic testing, as well as follow-up rates among patients receiving navigation support. The goal was to understand not only whether patients agreed to testing, but also whether education and navigation helped them move through the process.

What the Interim Results Show

Preliminary findings from April 2023 through July 2025 included 40 participants. At baseline, awareness and readiness were relatively high, with approximately 69.4% of patients reporting awareness of genomic testing and 75% indicating readiness to undergo testing. Awareness of clinical trials was reported by 80.6% of participants, with an equal percentage expressing readiness to participate.

Despite this baseline awareness, genomic testing rates improved substantially with intervention. Consent rates increased to 83% compared with 40% in usual care, and 62.5% of participants ultimately underwent genomic testing. Actionable genomic alterations were identified in 88% of tested patients, compared with 73% previously. Average turnaround times were 24 days for the OncoPanel and 12.5 days for the Rapid Heme Panel.

“They also cited logistical barriers, such as their insurers not paying for testing, or not being able to get to the testing site to get it done, or requiring an extra visit to get genomic testing done. And then, the biggest challenge was that it takes time between the test and the result, and then there is extra interpretation that is required,” Jackson noted.

Key Takeaways for Patients

The SURGE study highlights a practical, patient-focused approach to closing gaps in clinical trial access. Educational videos helped patients understand why genomic testing matters, and one-on-one navigation provided guidance through testing, results and next steps. Together, these strategies increased genomic testing rates and improved opportunities for trial participation.

“We don't know what we don't know unless we engage more diverse populations. It turns out that in many of our genomic studies where we are just looking at tumor mutations in a petri dish, for example, or in a lab, we don't have diverse representation of tumors, and tumors do show up differently in different people,” Jackson concluded.

Reference:

"Supporting utility and representation in genomics-based clinical trial enrollment (SURGE): Interim findings," by Dr. Nadine A. Jackson, et al. Journal of Clinical Oncology.

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