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Knowledge and Attitudes on Germline Pharmacogenomic Testing Among Clinical Oncologists
Mattie Monroe1,2, Hetanshi Naik1, James M Ford1,3
1Department of Genetics, Stanford University School of Medicine, Palo Alto, CA.
JCO Precision Oncology
|August 4, 2026
Summary
Oncologists show increasing awareness of pharmacogenomic (PGx) testing for cancer drugs, but barriers like uncertain utility hinder its use. Addressing these challenges is key for personalized cancer treatment.
Area of Science:
- Oncology
- Pharmacogenomics
- Clinical Pharmacy
Background:
- Clinical pharmacogenomic (PGx) testing is increasingly recognized for guiding cancer medication selection.
- Despite evidence, PGx adoption in oncology practice remains limited in the United States.
- Professional guidelines and recommendations are driving efforts to implement PGx in cancer care.
Purpose of the Study:
- To assess US oncologists' knowledge, attitudes, and perceived barriers regarding PGx-guided medication management.
- To evaluate the current state of PGx implementation for commonly prescribed oncology medications.
- To identify factors influencing the adoption of PGx testing in cancer treatment.
Main Methods:
- A survey was administered to US clinical oncologists from December 2023 to August 2024.
- The survey focused on oncology medications with actionable PGx guidelines (e.g., fluoropyrimidines, irinotecan, opiates).
- Participants were recruited through professional oncology organizations, including ASCO.
Main Results:
- 146 oncologists completed the survey; most were moderately familiar with PGx.
- Awareness of PGx for chemotherapy (92%) exceeded that for opiates/antidepressants (47%).
- Key barriers included uncertain utility, treatment delay concerns, and unclear guidelines for chemotherapy; lack of awareness and interpretation issues for opiates/antidepressants.
Conclusions:
- Oncologists' awareness and utilization of PGx testing are higher than previously reported.
- Identified barriers to PGx implementation in oncology are actionable and timely.
- Evolving drug labels and guidelines support increased PGx testing for cancer-related medications.
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