Barriers preventing the adoption of comprehensive cancer genomic profiling in the clinic

Expert Rev Mol Diagn. 2017 Jun;17(6):549-555. doi: 10.1080/14737159.2017.1319280. Epub 2017 Apr 18.

Abstract

Comprehensive cancer genomic profiling provides the opportunity to expose the various molecular aberrations potentially driving tumor progression. Consequently, the identity of these genetic drivers can be utilized to match a patient to the most appropriate targeted therapy, thereby increasing the probability of improved clinical outcome. Despite its capability of informing patient care, the adoption of comprehensive cancer genomic profiling in the clinic has not been widespread. The barriers surrounding its universal acceptance are attributed to both physician and patient perspectives. Areas covered: The following report discusses the various obstacles in place, including those related to clinical utility, education, insurance coverage, and clinical trials, which can deter physicians and patients from utilizing genomic profiling for therapeutic decision-making. Expert commentary: The authors review the recent growth and potential of clinical utility studies over the last two years, provide a suggestive framework for educational support, and comment on the use of social media to enhance clinical trial recruitment.

Keywords: Cancer; clinical utility; genomic profiling; next generation sequencing; targeted therapy.

Publication types

  • Review

MeSH terms

  • Biomarkers, Tumor / genetics*
  • Biomarkers, Tumor / standards
  • Costs and Cost Analysis
  • Genetic Testing / economics
  • Genetic Testing / statistics & numerical data*
  • Genome, Human*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Neoplasms / diagnosis
  • Neoplasms / genetics*
  • Precision Medicine / economics
  • Precision Medicine / psychology
  • Precision Medicine / statistics & numerical data*
  • Sequence Analysis, DNA / economics
  • Sequence Analysis, DNA / statistics & numerical data

Substances

  • Biomarkers, Tumor