Less than half of responding patients with cancer were previously familiar with pharmacogenomic testing and its possible benefits, according to the results of a survey conducted by the American Cancer Society Cancer Action Network (ACS CAN). Of the patients who did know about pharmacogenomic testing, only 45% learned of it through their healthcare practitioner.
The survey, published in JAMA Network Open, highlights patient perspectives regarding pharmacogenomic testing and their thoughts on serious drug adverse effects; and the study's results stress how more widespread testing is needed to further improve patient outcomes.
“Biomarker testing, including pharmacogenomic testing, can play a crucial role in improving cancer outcomes and decreasing cancer disparities, but many patients aren't aware of it or their insurance doesn't cover it," said study author Mark E. Fleury, PhD, Principal, Policy Development–Emerging Science at ACS CAN. "Cancer patients should be informed by their physicians about the benefits of pharmacogenomic testing, when appropriate, to ensure they can access the right treatment and the right dose at the right time. ACS CAN is working to expand access to comprehensive biomarker testing, including pharmacogenomics, in every state across the country, so that no patient is disadvantaged."
Study Methods and Population
In 2023, the ACS CAN released recommendations on pharmacogenomic testing, with steps to improve access to pharmacogenomic research and wider implementation, as the organization is trying to expand insurance coverage for comprehensive biomarker testing nationally. Pharmacogenomic testing prior to treatment can inform whether a patient is more likely to experience an adverse event from a medication or if they are not likely to respond to that treatment. Patient outcomes in oncology could improve with such knowledge and testing.
For the study, the ACS CAN released a Survivor Views web-based survey between June 26 and July 19, 2023, to patients with cancer and cancer survivors, all diagnosed with or treated for cancer in the past 7 years.
A total of 1,155 individuals responded to the survey, including 88% female patients or survivors, 8% Black or African American patients or survivors, 3% multiracial patients or survivors, and 66% patients with breast cancer or survivors of breast cancer.
Survey Questions and Findings
Participants were asked how concerned they would be about receiving a drug with a 1% severe adverse event rate. Fifty-six percent reported that they would be very or somewhat concerned about taking the drug, and 40% indicated they would not be very concerned or not at all concerned.
They were then informed of the definition of pharmacogenomics and the difference between pharmacogenomic testing and biomarker testing. Based on the definitions and information, 42% said they were previously aware of the possibility for pharmacogenomic testing prior to taking the survey, while 44% were previously unaware. Of the 42% who were aware, 33% learned about it through their own research, 8% found out about it from friends or family, and 4% read about it in medication information.
The participants were then asked if they would again be concerned about taking a medication with a 1% severe drug adverse effect but this time with the caveat of not receiving pharmacogenomic testing first to determine their potential for developing that severe effect. Seventy percent indicated they would be concerned without the testing while 24% reported they would not be concerned.
The study authors noted though, that the respondents were not stratified by treatment type or eligibility for pharmacogenomic testing, which could have impacted their awareness of such testing.
Disclosure: Funding for the survey was provided by grants from Bristol Myers Squibb. For full disclosures of the study authors, visit jamanetwork.com.
