Precision Medicine Is Changing the Roles of Healthcare Professionals, Scientists, and Research Staff: Learnings from a Childhood Cancer Precision Medicine Trial

Rebecca Daly; Kate Hetherington; Emily Hazell; Bethany R Wadling; Vanessa Tyrrell; Katherine M Tucker; Glenn M Marshall; David S Ziegler; Loretta M S Lau; Toby N Trahair; Tracey A O'Brien; Kiri Collins; Andrew J Gifford; Michelle Haber; Mark Pinese; David Malkin; Mark J Cowley; Jonathan Karpelowsky; Donna Drew; Chris Jacobs; Claire E Wakefield

doi:10.3390/jpm13071033

Precision Medicine Is Changing the Roles of Healthcare Professionals, Scientists, and Research Staff: Learnings from a Childhood Cancer Precision Medicine Trial

J Pers Med. 2023 Jun 23;13(7):1033. doi: 10.3390/jpm13071033.

Authors

Rebecca Daly^{1

2}, Kate Hetherington^{1

2}, Emily Hazell^{1

2

3}, Bethany R Wadling^{1

2

3}, Vanessa Tyrrell^{1

4}, Katherine M Tucker^{5

6}, Glenn M Marshall^{1

4

7}, David S Ziegler^{1

4

7}, Loretta M S Lau^{1

4

7}, Toby N Trahair^{1

4

7}, Tracey A O'Brien^{1

4

7}, Kiri Collins⁴, Andrew J Gifford^{1

4

8}, Michelle Haber⁴, Mark Pinese^{1

4}, David Malkin⁹, Mark J Cowley^{1

4

10}, Jonathan Karpelowsky^{11

12

13}, Donna Drew⁷, Chris Jacobs³, Claire E Wakefield^{1

2}

Affiliations

¹ Discipline of Pediatrics and Child Health, School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, NSW 2052, Australia.
² Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
³ Graduate School of Health, University of Technology Sydney, Sydney, NSW 2007, Australia.
⁴ Children's Cancer Institute, UNSW Sydney, Sydney, NSW 2052, Australia.
⁵ Hereditary Cancer Centre, Department of Medical Oncology, Prince of Wales Hospital, Randwick, NSW 2031, Australia.
⁶ Prince of Wales Clinical School, UNSW Sydney, Randwick, NSW 2031, Australia.
⁷ Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
⁸ Anatomical Pathology, NSW Health Pathology, Prince of Wales Hospital, Randwick, NSW 2031, Australia.
⁹ Division of Haematology/Oncology, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada.
¹⁰ Kinghorn Centre for Clinical Genomics, Garvan Institute, Darlinghurst, NSW 2010, Australia.
¹¹ Department of Paediatric Surgery, Children's Hospital at Westmead, Westmead, NSW 2145, Australia.
¹² Children's Cancer Research Unit, Kids Research Institute, Children's Hospital at Westmead, Westmead, NSW 2145, Australia.
¹³ Division of Child and Adolescent Health, University of Sydney, Sydney, NSW 2145, Australia.

Abstract

Precision medicine programs aim to utilize novel technologies to identify personalized treatments for children with cancer. Delivering these programs requires interdisciplinary efforts, yet the many groups involved are understudied. This study explored the experiences of a broad range of professionals delivering Australia's first precision medicine trial for children with poor-prognosis cancer: the PRecISion Medicine for Children with Cancer (PRISM) national clinical trial of the Zero Childhood Cancer Program. We conducted semi-structured interviews with 85 PRISM professionals from eight professional groups, including oncologists, surgeons, clinical research associates, scientists, genetic professionals, pathologists, animal care technicians, and nurses. We analyzed interviews thematically. Professionals shared that precision medicine can add complexity to their role and result in less certain outcomes for families. Although many participants described experiencing a greater emotional impact from their work, most expressed very positive views about the impact of precision medicine on their profession and its future potential. Most reported navigating precision medicine without formal training. Each group described unique challenges involved in adapting to precision medicine in their profession. Addressing training gaps and meeting the specific needs of many professional groups involved in precision medicine will be essential to ensure the successful implementation of standard care.

Keywords: genomic sequencing; oncology; pediatric; precision medicine; workforce.

Grants and funding

R.D. is supported by Luminesce Alliance—Innovation for Children’s Health. Luminesce Alliance—Innovation for Children’s Health is a not-for-profit cooperative joint venture between the Sydney Children’s Hospitals Network, the Children’s Medical Research Institute, and the Children’s Cancer Institute. It has been established with the support of the NSW government to coordinate and integrate pediatric research. Luminesce Alliance is also affiliated with the University of Sydney and UNSW Sydney. K.H. is supported by the Cancer Institute Translational Program Grant (2021/TPG2112) as well as the Luminesce Alliance and the Zero Childhood Cancer National Personalised Medicine Program for children with high-risk cancer, a joint initiative of the Children’s Cancer Institute and the Kids Cancer Centre, Sydney Children’s Hospital, Randwick. CW is supported by the NHMRC of Australia (APP2008300). D.M. is supported in part by the CIBC Children’s Foundation Chair in Child Health Research (SickKids Foundation). The Behavioural Sciences Unit is proudly supported by the Kids with Cancer Foundation.