Grant: Travel Awards - Institute Community Support

Medication side effects are increasingly recognized as important and sometimes irreversible complications of cancer treatment. Anthracyclines and platinums are two groups of drugs used in the treatment of over 50% of childhood cancers. They are extremely effective, but can cause heart problems and hearing loss, respectively, in up to 70% of patients. Previous studies have found that there are certain genes that make some patients more likely than others to develop these side effects. In order to determine who is most at risk, genetic testing is now being done prior to each patient's cancer treatment. These test results are returned to oncologists and show where each individual patient's genetic risk of developing heart problems or hearing loss lies between the lowest and highest risk across all patients. Interviews were conducted with families and patients to determine how results were valued and utilized. 227 patients have received genetic testing and had their results returned to their oncologists. The first 140 patients have been reviewed to determine the impact these test results have had on their clinical care. 100% of results were described as being useful in decision-making by patients and/or oncologists. Additionally, for patients with the highest risk of heart or hearing problems, a change in treatment was order 30-35% of the time depending on the cancer type. These changes included more frequent monitoring of heart and hearing function, choosing an alternative treatment, or using a protective drug. In interviews, patients/families indicated that they felt more involved in treatment decision-making and reassured by understanding their genetic risk of developing these side effects. Genetic results for patient's risk of heart problems and hearing loss from anthracyclines and cisplatin were highly utilized by patients and oncologists in decision-making.