Healthcare professionals’ attitudes toward cancer precision medicine: A systematic review

Vetsch, Janine; Wakefield, Claire E.; Techakesari, P.; Warby, Meera; Ziegler, David S.; O’Brien, Tracey; Drinkwater, Caroline; Neeman, Naama; Tucker, Katherine

doi:10.1053/j.seminoncol.2019.05.001

Cited by 21 publications

(37 citation statements)

References 63 publications

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“…To our knowledge, our study is the first to assess clinicians' and scientists' experiences and professional challenges in the early stages of a national precision medicine trial for high-risk childhood cancers. In line with research reporting healthcare professional optimism about precision medicine [11], both clinicians and scientists in our study described early positive attitudes towards the PRISM trial. At the same time, participants were conservative in predicting changes to outcomes for current patients, and placed focus on the importance of managing families' expectations to avoid engendering 'false' hope.…”

Section: Discussionsupporting

confidence: 83%

“…Precision medicine has the potential to compound these emotional pressures by demanding new ways of working for non-genetics trained clinicians, including a heightened level of interdisciplinary engagement and increased familiarity with genomic medicine [2,[6][7][8][9][10]. Despite growing evidence that clinicians are hopeful about the clinical utility of precision medicine [11], they may not feel adequately skilled to interpret and communicate the results of advanced genomic sequencing to patients and their families [12,13]. Non-genetics-trained clinicians may feel particularly diffident interpreting and utilising information about germline variants in cancer predisposition genes [11,14].…”

Section: Introductionmentioning

confidence: 99%

“…Despite growing evidence that clinicians are hopeful about the clinical utility of precision medicine [11], they may not feel adequately skilled to interpret and communicate the results of advanced genomic sequencing to patients and their families [12,13]. Non-genetics-trained clinicians may feel particularly diffident interpreting and utilising information about germline variants in cancer predisposition genes [11,14].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

“Balancing Expectations with Actual Realities”: Conversations with Clinicians and Scientists in the First Year of a High-Risk Childhood Cancer Precision Medicine Trial

McGill

Wakefield

Hetherington

et al. 2020

JPM

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Precision medicine is changing cancer care and placing new demands on oncology professionals. Precision medicine trials for high-risk childhood cancer exemplify these complexities. We assessed clinicians' (n = 39) and scientists' (n = 15) experiences in the first year of the PRecISion Medicine for Children with Cancer (PRISM) trial for children and adolescents with high-risk cancers, through an in-depth semi-structured interview. We thematically analysed participants' responses regarding their professional challenges, and measured oncologists' knowledge of genetics and confidence with somatic and germline molecular test results. Both groups described positive early experiences with PRISM but were cognisant of managing parents' expectations. Key challenges for clinicians included understanding and communicating genomic results, balancing biopsy risks, and drug access. Most oncologists rated 'good' knowledge of genetics, but a minority were 'very confident' in interpreting (25%), explaining (34.4%) and making treatment recommendations (18.8%) based on somatic genetic test results. Challenges for scientists included greater emotional impact of their work and balancing translational outputs with academic productivity. Continued tracking of these challenges across the course of the trial, while assessing the perspectives of a wider range of stakeholders, is critical to drive the ongoing development of a workforce equipped to manage the demands of paediatric precision medicine.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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“Balancing Expectations with Actual Realities”: Conversations with Clinicians and Scientists in the First Year of a High-Risk Childhood Cancer Precision Medicine Trial

McGill

Wakefield

Hetherington

et al. 2020

JPM

View full text Add to dashboard Cite

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“…Nevertheless, they contrasted with the observations made in the literature about more experienced health professionals. Indeed, it appears that experienced health professionals have concerns regarding PM and its applications [21]. We supposed that in the medical practice, the terrain experience can lead to a more nuanced view of PM and its results.…”

Section: Discussionmentioning

confidence: 98%

“…However, given the confusion of both patients and the general population toward the understanding of genetics and genomics [16][17][18][19], unrealistic expectations toward PM can be observed [20]. For healthcare professionals, attitudes toward PM seem mixed [21]. Even if they are mostly positive toward PM, professionals can express many concerns regarding potential issues engendered by PM (or its constitutive elements) such as a lack of knowledge concerning genetics and genomics, a lack of guidelines or an inability to explain the results of somatic testing to patients.…”

Section: Introductionmentioning

confidence: 99%

Definition of Personalized Medicine and Targeted Therapies: Does Medical Familiarity Matter?

Fournier

Prébet

Dormal

et al. 2021

JPM

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Personalized medicine (PM) is increasingly becoming a topic of discussion in public health policies and media. However, there is no consensus among definitions of PM in the scientific literature and the terms used to designate it, with some definitions emphasizing patient-centered aspects and others emphasizing biomedical aspects. Furthermore, terms used to refer to PM (e.g., “pharmacogenomics” or, more often, “targeted therapies”) are diverse and differently used. To our knowledge, no study has apprehended the differences of definition and attitudes toward personalized medicine and targeted therapies according to level of familiarity with the medical field. Our cohort included 349 French students from three different academic fields, which modulated their familiarity level with the medical field. They were asked to associate words either to “personalized medicine” or “target therapies”. Then, they were asked to give an emotional valence to their associations. Results showed that nonfamiliar students perceived PM as more positive than targeted therapies (TT), whereas familiar students showed no difference. Only familiar students defined PM and TT with technical aspects such as genetics or immunology. Further studies are needed in the field in order to determine which other factors could influence the definitions of PM and TT and determine how these definitions could have an impact in a clinical setting.

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Understanding communication between patients and healthcare professionals regarding comprehensive biomarker testing in precision oncology: A scoping review

Pichler,

Mumm,

Dehar

et al. 2024

Cancer Medicine

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BackgroundPrecision oncology, using comprehensive biomarker testing (cBT) to inform individual cancer diagnosis, prognosis and treatment, includes increasingly complex technology and clinical data sets. People impacted by cancer (patients and caregivers) and healthcare professionals (HCPs) face distinct challenges in navigating the cBT and personalized treatment landscape. This review summarizes evidence regarding cBT‐related communication between people impacted by cancer and HCPs and identifies important avenues for future research in precision oncology.MethodsA scoping review was conducted using records published in PubMed during January 2017–August 2022, focusing on the breadth of topics on patient‐HCP communication and knowledge resources used by HCPs as guidance in cBT‐related communication. Data were extracted from records meeting inclusion criteria, and findings were summarized according to main topics.ResultsThe search identified 287 unique records and data were extracted from 42 records, including nine from expert input. Most records originated from the United States included patients with different types of cancer, and oncologists were the main HCPs. Patients' motivation for undergoing cBT and receiving results was generally high in different settings. However, patients' understanding of cBT‐related concepts was limited, and their knowledge and information preferences changed based on cBT implications and significance to family members. HCPs were valued by patients as a trusted source of information. Limited evidence was available on HCPs' information‐seeking behavior and factors influencing cBT‐related knowledge and confidence, often self‐reported as insufficient.ConclusionsPatient education by knowledgeable and confident HCPs, information management and a caring patient‐HCP relationship communicating continuity of care regardless of cBT results are crucial to empower patients and shared decision‐making in precision oncology. More data on the process and structure of cBT‐related communication, distinction between and characterization of different timepoints of patient‐HCP interactions are needed.

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Healthcare professionals’ attitudes toward cancer precision medicine: A systematic review

Cited by 21 publications

References 63 publications

“Balancing Expectations with Actual Realities”: Conversations with Clinicians and Scientists in the First Year of a High-Risk Childhood Cancer Precision Medicine Trial

“Balancing Expectations with Actual Realities”: Conversations with Clinicians and Scientists in the First Year of a High-Risk Childhood Cancer Precision Medicine Trial

Definition of Personalized Medicine and Targeted Therapies: Does Medical Familiarity Matter?

Understanding communication between patients and healthcare professionals regarding comprehensive biomarker testing in precision oncology: A scoping review

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