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Comfort with Pharmacogenetic Testing Amongst Pediatric Oncology Providers and Their Patients
Catriona Mowbray1, Joyce Turner2, Jiaxiang Gai3
1Center of Cancer and Blood Disorders, 8404Children's National Hospital, Washington, DC, USA.
Insights
Pharmacogenetic (PGx) testing offers personalized medicine benefits for pediatric cancer patients. However, providers and families need education on PGx testing, interpretation, and data privacy concerns before routine implementation.
Area of Science:
- Pharmacogenomics
- Personalized Medicine
- Pediatric Oncology
Background:
- Pharmacogenetic (PGx) testing is a key component of personalized medicine, aiming to optimize treatment efficacy and minimize adverse effects in pediatric oncology.
- Nurses require a comprehensive understanding of provider, patient, and family perspectives on PGx testing implementation, including timing, scope, interpretation, and integration into care.
- Addressing knowledge gaps and concerns is crucial for the routine adoption of PGx testing in pediatric cancer care.
Purpose of the Study:
- To assess the knowledge and concerns of healthcare providers and family caregivers regarding pharmacogenetic (PGx) testing in pediatric oncology.
- To identify barriers and facilitators for the integration of PGx testing into routine care for children with cancer.
- To inform educational strategies for providers and families to support the effective use of PGx testing.
Main Methods:
- Surveys were administered to providers and family caregivers of children with cancer as part of a larger PGx study.
- Caregivers who declined participation in the main study were also invited to complete the survey.
- Statistical analyses, including Chi-square tests and two-sample t-tests, were used to compare variables between groups.
Main Results:
- Surveys were completed by 102 participants from the main study, 12 families who declined, and 29 providers, with high response rates.
- Families not participating in the main study showed less interest and comfort with PGx results.
- Both families and providers expressed concerns regarding insurance discrimination and testing costs. Providers desired more support in ordering and interpreting PGx tests.
Conclusions:
- Healthcare providers exhibit hesitancy towards PGx testing, particularly in interpreting and applying results.
- Families are receptive to personalized prescribing but anxious about the privacy and accessibility of their child's genetic information.
- Enhanced education for providers, including nurses, on PGx tests and for families on the testing process, privacy, and data sharing is essential for successful implementation.
Abstract:
Background: Pharmacogenetic (PGx) testing, a component of personalized medicine, aims to ensure treatment efficacy while reducing side effects and symptoms. Before this testing becomes routine in the pediatric oncology population, nurses need to understand the knowledge and concerns of providers, patients, and family members with regard to the timing, extent, interpretation, and incorporation of PGx testing. Methods: As part of a comprehensive PGx study (larger study) for children diagnosed with cancer, we surveyed providers and caregivers of children with cancer about their knowledge of and comfort with PGx testing. Caregivers who declined to participate in the larger PGx study were also asked to participate in the survey. Chi-square tests and a two-sample t-test were used to compare variables. Results: One hundred and two participants from the larger PGx study and 12 families who refused (response rate of 77% and 54%, respectively) as well as 29 providers (88%) completed surveys. Families not on the study were less interested in and comfortable with PGx results. Both groups were concerned about health or life insurance discrimination and payment. Providers would like support in ordering PGx testing and interpreting PGx. Discussion: Providers remain wary of most PGx testing, uncomfortable with interpreting and applying the results. Families are interested in the possibilities of personalized prescribing while worried about who has access to their child's genetic information. Further education on relevant tests for providers, including nurses, and the testing process for families, including details on privacy and sharing of genetic information, appear necessary.
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