Cargando…

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

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 C...

Descripción completa

Detalles Bibliográficos
Autores principales: McGill, Brittany C., Wakefield, Claire E., Hetherington, Kate, Munro, Lachlan J., Warby, Meera, Lau, Loretta, Tyrrell, Vanessa, Ziegler, David S., O’Brien, Tracey A., Marshall, Glenn M., Malkin, David, Hansford, Jordan R., Tucker, Katherine M., Vetsch, Janine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151613/
https://www.ncbi.nlm.nih.gov/pubmed/32075154
http://dx.doi.org/10.3390/jpm10010009
_version_ 1783521291256463360
author McGill, Brittany C.
Wakefield, Claire E.
Hetherington, Kate
Munro, Lachlan J.
Warby, Meera
Lau, Loretta
Tyrrell, Vanessa
Ziegler, David S.
O’Brien, Tracey A.
Marshall, Glenn M.
Malkin, David
Hansford, Jordan R.
Tucker, Katherine M.
Vetsch, Janine
author_facet McGill, Brittany C.
Wakefield, Claire E.
Hetherington, Kate
Munro, Lachlan J.
Warby, Meera
Lau, Loretta
Tyrrell, Vanessa
Ziegler, David S.
O’Brien, Tracey A.
Marshall, Glenn M.
Malkin, David
Hansford, Jordan R.
Tucker, Katherine M.
Vetsch, Janine
author_sort McGill, Brittany C.
collection PubMed
description 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.
format Online
Article
Text
id pubmed-7151613
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-71516132020-04-20 “Balancing Expectations with Actual Realities”: Conversations with Clinicians and Scientists in the First Year of a High-Risk Childhood Cancer Precision Medicine Trial McGill, Brittany C. Wakefield, Claire E. Hetherington, Kate Munro, Lachlan J. Warby, Meera Lau, Loretta Tyrrell, Vanessa Ziegler, David S. O’Brien, Tracey A. Marshall, Glenn M. Malkin, David Hansford, Jordan R. Tucker, Katherine M. Vetsch, Janine J Pers Med Article 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. MDPI 2020-02-14 /pmc/articles/PMC7151613/ /pubmed/32075154 http://dx.doi.org/10.3390/jpm10010009 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
McGill, Brittany C.
Wakefield, Claire E.
Hetherington, Kate
Munro, Lachlan J.
Warby, Meera
Lau, Loretta
Tyrrell, Vanessa
Ziegler, David S.
O’Brien, Tracey A.
Marshall, Glenn M.
Malkin, David
Hansford, Jordan R.
Tucker, Katherine M.
Vetsch, Janine
“Balancing Expectations with Actual Realities”: Conversations with Clinicians and Scientists in the First Year of a High-Risk Childhood Cancer Precision Medicine Trial
title “Balancing Expectations with Actual Realities”: Conversations with Clinicians and Scientists in the First Year of a High-Risk Childhood Cancer Precision Medicine Trial
title_full “Balancing Expectations with Actual Realities”: Conversations with Clinicians and Scientists in the First Year of a High-Risk Childhood Cancer Precision Medicine Trial
title_fullStr “Balancing Expectations with Actual Realities”: Conversations with Clinicians and Scientists in the First Year of a High-Risk Childhood Cancer Precision Medicine Trial
title_full_unstemmed “Balancing Expectations with Actual Realities”: Conversations with Clinicians and Scientists in the First Year of a High-Risk Childhood Cancer Precision Medicine Trial
title_short “Balancing Expectations with Actual Realities”: Conversations with Clinicians and Scientists in the First Year of a High-Risk Childhood Cancer Precision Medicine Trial
title_sort “balancing expectations with actual realities”: conversations with clinicians and scientists in the first year of a high-risk childhood cancer precision medicine trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151613/
https://www.ncbi.nlm.nih.gov/pubmed/32075154
http://dx.doi.org/10.3390/jpm10010009
work_keys_str_mv AT mcgillbrittanyc balancingexpectationswithactualrealitiesconversationswithcliniciansandscientistsinthefirstyearofahighriskchildhoodcancerprecisionmedicinetrial
AT wakefieldclairee balancingexpectationswithactualrealitiesconversationswithcliniciansandscientistsinthefirstyearofahighriskchildhoodcancerprecisionmedicinetrial
AT hetheringtonkate balancingexpectationswithactualrealitiesconversationswithcliniciansandscientistsinthefirstyearofahighriskchildhoodcancerprecisionmedicinetrial
AT munrolachlanj balancingexpectationswithactualrealitiesconversationswithcliniciansandscientistsinthefirstyearofahighriskchildhoodcancerprecisionmedicinetrial
AT warbymeera balancingexpectationswithactualrealitiesconversationswithcliniciansandscientistsinthefirstyearofahighriskchildhoodcancerprecisionmedicinetrial
AT lauloretta balancingexpectationswithactualrealitiesconversationswithcliniciansandscientistsinthefirstyearofahighriskchildhoodcancerprecisionmedicinetrial
AT tyrrellvanessa balancingexpectationswithactualrealitiesconversationswithcliniciansandscientistsinthefirstyearofahighriskchildhoodcancerprecisionmedicinetrial
AT zieglerdavids balancingexpectationswithactualrealitiesconversationswithcliniciansandscientistsinthefirstyearofahighriskchildhoodcancerprecisionmedicinetrial
AT obrientraceya balancingexpectationswithactualrealitiesconversationswithcliniciansandscientistsinthefirstyearofahighriskchildhoodcancerprecisionmedicinetrial
AT marshallglennm balancingexpectationswithactualrealitiesconversationswithcliniciansandscientistsinthefirstyearofahighriskchildhoodcancerprecisionmedicinetrial
AT malkindavid balancingexpectationswithactualrealitiesconversationswithcliniciansandscientistsinthefirstyearofahighriskchildhoodcancerprecisionmedicinetrial
AT hansfordjordanr balancingexpectationswithactualrealitiesconversationswithcliniciansandscientistsinthefirstyearofahighriskchildhoodcancerprecisionmedicinetrial
AT tuckerkatherinem balancingexpectationswithactualrealitiesconversationswithcliniciansandscientistsinthefirstyearofahighriskchildhoodcancerprecisionmedicinetrial
AT vetschjanine balancingexpectationswithactualrealitiesconversationswithcliniciansandscientistsinthefirstyearofahighriskchildhoodcancerprecisionmedicinetrial