Parents' expectations, preferences, and recall of germline findings in a childhood cancer precision medicine trial.

genomic medicine germline mutation hereditary cancer syndromes neoplasms pediatrics precision medicine

Journal

Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236

Informations de publication

Date de publication:
15 11 2023
Historique:
revised: 17 04 2023
received: 29 08 2022
accepted: 15 05 2023
medline: 30 10 2023
pubmed: 29 6 2023
entrez: 29 6 2023
Statut: ppublish

Résumé

Germline genome sequencing in childhood cancer precision medicine trials may reveal pathogenic or likely pathogenic variants in cancer predisposition genes in more than 10% of children. These findings can have implications for diagnosis, treatment, and the child's and family's future cancer risk. Understanding parents' perspectives of germline genome sequencing is critical to successful clinical implementation. A total of 182 parents of 144 children (<18 years of age) with poor-prognosis cancers enrolled in the Precision Medicine for Children with Cancer trial completed a questionnaire at enrollment and after the return of their child's results, including clinically relevant germline findings (received by 13% of parents). Parents' expectations of germline genome sequencing, return of results preferences, and recall of results received were assessed. Forty-five parents (of 43 children) were interviewed in depth. At trial enrollment, most parents (63%) believed it was at least "somewhat likely" that their child would receive a clinically relevant germline finding. Almost all expressed a preference to receive a broad range of germline genomic findings, including variants of uncertain significance (88%). Some (29%) inaccurately recalled receiving a clinically relevant germline finding. Qualitatively, parents expressed confusion and uncertainty after the return of their child's genome sequencing results by their child's clinician. Many parents of children with poor-prognosis childhood cancer enrolled in a precision medicine trial expect their child may have an underlying cancer predisposition syndrome. They wish to receive a wide scope of information from germline genome sequencing but may feel confused by the reporting of trial results.

Sections du résumé

BACKGROUND
Germline genome sequencing in childhood cancer precision medicine trials may reveal pathogenic or likely pathogenic variants in cancer predisposition genes in more than 10% of children. These findings can have implications for diagnosis, treatment, and the child's and family's future cancer risk. Understanding parents' perspectives of germline genome sequencing is critical to successful clinical implementation.
METHODS
A total of 182 parents of 144 children (<18 years of age) with poor-prognosis cancers enrolled in the Precision Medicine for Children with Cancer trial completed a questionnaire at enrollment and after the return of their child's results, including clinically relevant germline findings (received by 13% of parents). Parents' expectations of germline genome sequencing, return of results preferences, and recall of results received were assessed. Forty-five parents (of 43 children) were interviewed in depth.
RESULTS
At trial enrollment, most parents (63%) believed it was at least "somewhat likely" that their child would receive a clinically relevant germline finding. Almost all expressed a preference to receive a broad range of germline genomic findings, including variants of uncertain significance (88%). Some (29%) inaccurately recalled receiving a clinically relevant germline finding. Qualitatively, parents expressed confusion and uncertainty after the return of their child's genome sequencing results by their child's clinician.
CONCLUSIONS
Many parents of children with poor-prognosis childhood cancer enrolled in a precision medicine trial expect their child may have an underlying cancer predisposition syndrome. They wish to receive a wide scope of information from germline genome sequencing but may feel confused by the reporting of trial results.

Identifiants

pubmed: 37382186
doi: 10.1002/cncr.34917
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

3620-3632

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2023 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.

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Auteurs

Brittany C McGill (BC)

School of Clinical Medicine, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia.
Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.

Claire E Wakefield (CE)

School of Clinical Medicine, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia.
Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.

Katherine M Tucker (KM)

Hereditary Cancer Centre, Prince of Wales Hospital, Sydney, New South Wales, Australia.
Prince of Wales Clinical School, UNSW Sydney, Sydney, New South Wales, Australia.

Rebecca A Daly (RA)

School of Clinical Medicine, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia.
Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.

Mark W Donoghoe (MW)

Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.
Stats Central, UNSW Sydney, Sydney, New South Wales, Australia.

Janine Vetsch (J)

School of Clinical Medicine, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia.
Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.

Meera Warby (M)

Hereditary Cancer Centre, Prince of Wales Hospital, Sydney, New South Wales, Australia.
Children's Cancer Institute, UNSW Sydney, Sydney, New South Wales, Australia.

Noemi A Fuentes-Bolanos (NA)

School of Clinical Medicine, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia.
Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.
Children's Cancer Institute, UNSW Sydney, Sydney, New South Wales, Australia.

Kristine Barlow-Stewart (K)

Children's Cancer Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Faculty of Medicine and Health, Royal North Shore Hospital, Sydney, New South Wales, Australia.

Judy Kirk (J)

Familial Cancer Service, Westmead Hospital, Sydney, New South Wales, Australia.
Sydney Medical School, Westmead Institute for Medical Research, Sydney, New South Wales, Australia.

Eliza Courtney (E)

School of Clinical Medicine, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia.
Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.
Children's Cancer Institute, UNSW Sydney, Sydney, New South Wales, Australia.

Tracey A O'Brien (TA)

School of Clinical Medicine, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia.
Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.
Children's Cancer Institute, UNSW Sydney, Sydney, New South Wales, Australia.

Glenn M Marshall (GM)

School of Clinical Medicine, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia.
Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.
Children's Cancer Institute, UNSW Sydney, Sydney, New South Wales, Australia.

Mark Pinese (M)

School of Clinical Medicine, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia.
Children's Cancer Institute, UNSW Sydney, Sydney, New South Wales, Australia.

Mark J Cowley (MJ)

School of Clinical Medicine, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia.
Children's Cancer Institute, UNSW Sydney, Sydney, New South Wales, Australia.

Vanessa Tyrrell (V)

School of Clinical Medicine, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia.
Children's Cancer Institute, UNSW Sydney, Sydney, New South Wales, Australia.

Rebecca J Deyell (RJ)

Division of Paediatric Hematology/Oncology/Bone Marrow Transplantation, British Columbia Children's Hospital and Research Institute, Vancouver, British Columbia, Canada.

David S Ziegler (DS)

School of Clinical Medicine, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia.
Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.
Children's Cancer Institute, UNSW Sydney, Sydney, New South Wales, Australia.

Kate Hetherington (K)

School of Clinical Medicine, University of New South Wales (UNSW) Sydney, Sydney, New South Wales, Australia.
Kids Cancer Centre, Sydney Children's Hospital, Sydney, New South Wales, Australia.

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