ArticleBMC cancer2022
Preemptive pharmacogenetic testing to guide chemotherapy dosing in patients with gastrointestinal malignancies: a qualitative study of barriers to implementation.
Article in BMC cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06559462 (Optimizing Nudge Strategies to Increase the Adoption of DPYD Testing in Patients With Gastrointestinal), which is not on this map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Optimizing Nudge Strategies to Increase the Adoption of DPYD Testing in Patients With Gastrointestinal (GI) Malignancies Treated With Fluoropyrimidines.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Healthcare professionals' and consumers' knowledge, attitudes, perspectives, and education needs in oncology pharmacogenomics: A systematic review.Clinical and translational science · 2023Pooled it
- Implementation ofJCO precision oncology · 2025Trial
- Bridging the pharmacogenomics gap: a survey of healthcare workers in South-Western Nigeria.The pharmacogenomics journal · 2026Article
- Survival of patients with colorectal or pancreatic cancer who receivedThe Lancet regional health. Europe · 2026Article
- Carcinogenic Medications: A Review of Specific Agents and Molecular Mechanisms of Carcinogenesis.Cancer reports (Hoboken, N.J.) · 2026Review
- Model-based clinical utility of pharmacogenetic testing and its potential population impact on the use of essential medicines in Zimbabwe.Frontiers in pharmacology · 2026Article
- Implementation of preemptive pharmacogenetic testing: progress, puzzles and priorities from an implementation science perspective.Frontiers in pharmacology · 2026Review
- A Guide for Implementing DPYD Genotyping for Systemic Fluoropyrimidines into Clinical Practice.Clinical pharmacology and therapeutics · 2025Review
- How is Value Defined in Molecular Testing in Cancer? A Scoping Review.Applied health economics and health policy · 2025Article
- Implementation of Pharmacogenomics Testing in Daily Clinical Practice: Perspectives of Prescribers from Two Canadian Armed Forces Medical Clinics.Journal of personalized medicine · 2025Article
- Recommendations for pharmacogenetic testing in clinical practice guidelines in the US.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2024Review
- A qualitative approach to assess the opinion of physicians about the challenges and prospects of pharmacogenomic testing implementation in clinical practice in Greece.Human genomics · 2024Article
- Strategies for DPYD testing prior to fluoropyrimidine chemotherapy in the US.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Real-World Impact of an In-House Dihydropyrimidine Dehydrogenase (JCO precision oncology · 2024Observational
- Overcoming Barriers to Discovery and Implementation of Equitable Pharmacogenomic Testing in Oncology.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Review
- Patient and healthcare professional acceptability of pharmacogenetic screening for DPYD and UGT1A1: A cross sectional survey.Clinical and translational science · 2023Article
- Pharmacogenomics implementation across multiple clinic settings: a qualitative evaluation.Pharmacogenomics · 2023Article
- Article
- Opportunities for personalizing colorectal cancer care: an analysis of SEER-medicare data.The pharmacogenomics journal · 2022Article
- Implementing Pharmacogenetic Testing in Gastrointestinal Cancers (IMPACT-GI): Study Protocol for a Pragmatic Implementation Trial for EstablishingFrontiers in oncology · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundPharmacogenetic (PGx) testing for germline variants in the DPYD and UGT1A1 genes can be used to guide fluoropyrimidine and irinotecan dosing, respectively. Despite the known association between PGx variants and chemotherapy toxicity, preemptive testing prior to chemotherapy initiation is rarely performed in routine practice.
methodsWe conducted a qualitative study of oncology clinicians to identify barriers to using preemptive PGx testing to guide chemotherapy dosing in patients with gastrointestinal malignancies. Each participant completed a semi-structured interview informed by the Consolidated Framework for Implementation Research (CFIR). Interviews were analyzed using an inductive content analysis approach.
resultsParticipants included sixteen medical oncologists and nine oncology pharmacists from one academic medical center and two community hospitals in Pennsylvania. Barriers to the use of preemptive PGx testing to guide chemotherapy dosing mapped to four CFIR domains: intervention characteristics, outer setting, inner setting, and characteristics of individuals. The most prominent themes included 1) a limited evidence base, 2) a cumbersome and lengthy testing process, and 3) a lack of insurance coverage for preemptive PGx testing. Additional barriers included clinician lack of knowledge, difficulty remembering to order PGx testing for eligible patients, challenges with PGx test interpretation, a questionable impact of preemptive PGx testing on clinical care, and a lack of alternative therapeutic options for some patients found to have actionable PGx variants.
conclusionsSuccessful adoption of preemptive PGx-guided chemotherapy dosing in patients with gastrointestinal malignancies will require a multifaceted effort to demonstrate clinical effectiveness while addressing the contextual factors identified in this study.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.