Oncologists unsure about use of complex genomic tests in cancer

The coming genomic-testing revolution has practicing oncologists uneasy about how such tests should be used and how to return results to patients, according to a physician survey published recently in the Journal of Clinical Oncology. Cancer researcher Stacy Gray and her colleagues at Dana Farber Cancer Institute surveyed 160 of their colleagues ahead of a planned research project to implement predictive multigene genomic testing at their institution. They found a high degree of variability in how physicians planned to incorporate the predictive genomic tests into practice. Physicians who were confident and comfortable in their knowledge of genomics planned to test more patients than did those with less confidence. Alarmingly, about a quarter of those surveyed reported having little or no confidence in their knowledge of genomics or in their ability to base treatment recommendations on genomic data (22% and 26%, respectively). In addition, 23% said that they would only rarely or sometimes explain clinically relevant findings to patients. Survey participants also varied widely in the language and terminology they planned to use in explaining results. The authors suggest that without standardized language, physicians run the risk of confusing patients and making treatment decisions more difficult, indicating an urgent need for innovative education to help cancer physicians integrate genomic data into their clinical practices. —Karyn Hede, News Editor

Proactive intervention urged as NIPT goes global

In the face of escalating concern about how noninvasive prenatal testing (NIPT) is being applied in developing countries, Subhashini Chandrasekharan, an assistant professor at Duke University’s Institute for Genome Sciences and Policy, and colleagues are calling for research into how commercial NIPT is being disseminated and its impact on prenatal care. In a commentary published in Science Translational Medicine, they outline several areas of concern pertaining to the dissemination of these tests and the general lack of regulatory control in many countries. For example, although both China and India forbid returning information to parents about fetal sex to help prevent sex-based abortion, those laws are weakly enforced (see the review by Madan and Breuning and the commentary by Benn in this issue). The authors note that many prenatal tests are offered in other countries through licensed purveyors of United States–produced tests, but that US companies rely on local regulatory agencies to enforce local laws. In addition, patients may be able to send samples to jurisdictions where such laws do not apply. Decisions by companies, local and national governments, nongovernmental organizations, professional societies, regulatory agencies, and international agencies will determine how effectively and ethically NIPT is implemented. The authors argue that promotion of these tests without societal safeguards in place may negate the benefit the tests are designed to provide. —Karyn Hede, News Editor

Genetics in Medicine | Mission Statement

Genetics in Medicine is a monthly journal committed to the timely publication of:

  • Original reports which enhance the knowledge and practice of medical genetics

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