OBJECTIVES:

While integration of next-generation sequencing (NGS) techniques has the potential to improve care and outcomes for certain pediatric oncology patients, data are sparse assessing utilization in routine clinical practice. This survey-based study aimed to examine physician perceptions of NGS-based testing utilization among practicing pediatric oncologists in the U.S.

METHODS:

Pediatric oncologists responded to questions related to NGS-based approaches for pediatric patients in the U.S during a virtual meeting held in October 2021. Descriptive statistics were used to analyze the results.

RESULTS:

Fifty-three U.S. pediatric oncologists participated, not all answered every survey question. Nearly all (90%;48/53) use NGS techniques to determine the ideal therapy across any cancer indication for at least some of their patients. Most physicians (N=49) stated they order genetic testing for central nervous system tumors (76%), acute lymphoblastic leukemia (73%), neuroblastoma (47%), and acute myeloid leukemia (35%). The most common used techniques are NGS panels (98%; 50/51), whole-exome sequencing (73%; 37/51), and RNA sequencing (51%; 26/51). Almost half (47%; 22/47) order NGS-based testing prior to first-line treatment in the relapsed/metastatic setting. Among this group of pediatric oncologists, the most common perceived advantage to NGS testing is information generation resulting from screening multiple genes (57%; 29/51); the most common perceived barriers to NGS testing were pre-authorizations and reimbursement issues, 45% each (23/51); the most common challenge faced with NGS testing is receiving complex or unactionable results (67%; 34/51). Over two-thirds reported that more clinical evidence demonstrating improved patient outcomes and financial support for patients would increase their use of genomic testing.

CONCLUSIONS:

Despite high levels of utilization, our findings demonstrate a need for further optimization of the integration of genomic sequencing in the pediatric oncology setting. Education for pediatric oncologists about clinical utility and increased financial support for patients may improve NGS-based testing utilization and adoption to improve patient outcomes and care.