Pharmacogenomics in pediatric oncology: Australian adolescent or young adult and caregiver perspectives.

Purpose: Preemptive pharmacogenomic (PGx) testing in pediatric oncology patients could reduce toxicity and improve efficacy of medications yet remains underutilized. Consumer identified implementation barriers have not been extensively explored nor included adolescent or young adult (AYA) patient perspectives. This study describes Australian pediatric oncology consumer perspectives on PGx testing, elucidating barriers to implementation. Methods: A theory-informed, quantitative survey was used to assess knowledge and attitudes toward PGx in 38 AYA patients and 66 caregivers. Additionally, AYAs were assessed for autonomy using a validated scale. Results: Participants viewed PGx testing positively, and 98% at least "somewhat agreed" that they would want to be tested/want their child to be tested. Concerns were identified in both AYA patient and caregiver groups, primarily the possibility of insurance discrimination and data security. Almost 90% of AYA patients expressed a desire for direct involvement in decisions regarding their PGx testing. However, the mean autonomy score (15.2) suggests that many felt they were not consistently given the opportunity to participate in decisions about their own lives. Conclusion: Despite positive attitudes toward PGx testing, pediatric oncology consumers still have some concerns that need to be addressed for successful implementation. Additionally, AYA patients should be included in PGx processes and implementation design.