Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website https://jocmr.elmerjournals.com

Original Article

Volume 18, Number 10, October 2026, pages 784-794

Precision Oncology: Cancer Specialists’ Perspectives on Molecular Profiling, Targeted Therapy, and Barriers to Access

Figures

↓  Figure 1. Molecular tests most commonly requested by cancer specialists in Bangladesh. ALK: anaplastic lymphoma kinase; BRCA1/BRCA2: breast cancer susceptibility gene 1/2; EGFR: epidermal growth factor receptor; ER: estrogen receptor; HER-2: human epidermal growth factor receptor 2; KRAS/BRAF: Kirsten rat sarcoma viral oncogene homolog/B-Raf proto-oncogene; MMR: mismatch repair; MSI: microsatellite instability; NGS: next-generation sequencing; PD-L1: programmed death-ligand 1; PR: progesterone receptor; ROS1: ROS proto-oncogene 1.
Figure 1.
↓  Figure 2. Cancer specialists’ agreement that targeted therapy should become standard practice in Bangladesh where clinically indicated.
Figure 2.
↓  Figure 3. Interventions considered most likely to improve access to molecular profiling and targeted therapy in Bangladesh.
Figure 3.

Tables

↓  Table 1. Survey Questionnaire and Response Options
 
DomainSurvey question/itemResponse options
ALK: anaplastic lymphoma kinase; BRCA1/BRCA2: breast cancer susceptibility gene 1/2; EGFR: epidermal growth factor receptor; ER: estrogen receptor; HER2: human epidermal growth factor receptor 2; KRAS/BRAF: Kirsten rat sarcoma viral oncogene homolog/B-Raf proto-oncogene; MMR: mismatch repair; MSI: microsatellite instability; NGS: next-generation sequencing; PD-L1: programmed death-ligand 1; PR: progesterone receptor; ROS1: ROS proto-oncogene 1.
Participant characteristics1. What is your primary specialty?Clinical Oncology; Radiation Oncology; Surgical Oncology; Medical Oncology; Hematology; Other (Please specify)
2. Years in independent clinical practice< 5 years; 5–10 years; 11–20 years; > 20 years
3. Identify your primary roleClinician; Educator; Researcher
4. Which of the following is your current primary practice setting?Government Hospital; University Hospital; Private Hospital; Autonomous nonprofit Institution/Hospital
5. Which level of healthcare facility best describes your current primary practice setting?Primary care hospital/center; Secondary-level hospital; Tertiary referral hospital; Specialized cancer center; Multiple practice settings; Other (please specify)
6. Which of the following is the approximate number of cancer patients managed by you per month?< 50; 50–100; 100–200; > 200
Molecular profiling and targeted therapy practices7. How often do you recommend molecular profiling (genomic/biomarker testing) for eligible cancer patients?Never; Rarely (less than 25% of cases); Sometimes (25–50% of cases); Often (more than 50% of cases); Always
8. Which molecular tests do you commonly request? (Select all that apply)ER, PR, HER2; EGFR; ALK; ROS1; KRAS/BRAF; MSI/MMR; PD-L1; NGS Panel; BRCA1/BRCA2; Other (Please specify)
9. Approximately what proportion of your patients who are eligible ultimately receive targeted therapy?< 10%; 10–25%; 26–50%; 51–75%; > 75%
Perceived barriers10. High cost of molecular testing1 = Not a barrier to 5 = Very major barrier
11. High cost of targeted therapy1 = Not a barrier to 5 = Very major barrier
12. Limited availability of testing facilities within Bangladesh1 = Not a barrier to 5 = Very major barrier
13. Limited availability of targeted therapy/supply issues1 = Not a barrier to 5 = Very major barrier
14. Long turnaround time for molecular testing results1 = Not a barrier to 5 = Very major barrier
15. Limited physician awareness/training regarding molecular-guided treatment1 = Not a barrier to 5 = Very major barrier
16. Limited local clinical guideline1 = Not a barrier to 5 = Very major barrier
17. Limited patient understanding or acceptance of molecular testing1 = Not a barrier to 5 = Very major barrier
Attitudes and potential interventions18. Targeted therapy should become standard practice in Bangladesh where indicated.1 = Strongly disagree to 5 = Strongly agree
19. Which intervention would MOST improve access to molecular profiling and targeted therapy? (Choose two)Reduced testing cost; Government-subsidized insurance coverage; More local laboratories; Physician education; Faster reporting; Increased drug availability

 

↓  Table 2. Demographics and Characteristics of the Study Participants
 
Characteristicn (%)
Primary specialty
  Clinical Oncology36 (69.2)
  Hematology5 (9.6)
  Medical Oncology4 (7.7)
  Radiation Oncology5 (9.6)
  Surgical Oncology2 (3.8)
Years in independent clinical practice
  < 5 years31 (59.6)
  5–10 years15 (28.8)
  11–20 years4 (7.7)
  > 20 years2 (3.8)
Primary practice setting
  Government hospital32 (61.5)
  Private hospital14 (26.9)
  Autonomous nonprofit institution/hospital4 (7.7)
  University hospital2 (3.8)
Level of healthcare facility
  Primary care hospital/center1 (1.9)
  Secondary-level hospital3 (5.8)
  Tertiary referral hospital17 (32.7)
  Specialized cancer center24 (46.2)
  Multiple practice settings6 (11.5)
  Other1 (1.9)
Approximate number of cancer patients managed per month
  < 5020 (38.5)
  50–10016 (30.8)
  100–2006 (11.5)
  > 20010 (19.2)

 

↓  Table 3. Survey Summary: Molecular Profiling and Targeted Therapy Practices Among Participating Cancer Specialists (N = 52)
 
Practice characteristicn (%)
Frequency of recommending molecular profiling for eligible patients
  Always9 (17.3)
  Often (> 50% of cases)18 (34.6)
  Sometimes (25–50% of cases)17 (32.7)
  Rarely (< 25% of cases)8 (15.4)
Proportion of eligible patients ultimately receiving targeted therapy
  < 10%22 (42.3)
  10–25%23 (44.2)
  26–50%6 (11.5)
  51–75%1 (1.9)

 

↓  Table 4. Perceived Barriers to Molecular Profiling and Targeted Therapy Among Cancer Specialists in Bangladesh (N = 52)
 
Perceived barrierMedian (IQR)Rating 4–5, n (%)
Barrier items were rated on a 5-point scale. Data are presented as median (IQR) and n (%) of respondents assigning a rating of 4 or 5. Higher ratings indicate a greater perceived barrier.
High cost of molecular testing5 (4–5)45 (86.5)
High cost of targeted therapy5 (4–5)46 (88.5)
Limited availability of testing facilities within Bangladesh4 (3–4)29 (55.8)
Limited availability of targeted therapy/supply issues3 (2–4)18 (34.6)
Long turnaround time for molecular testing results3 (2–4)25 (48.1)
Limited physician awareness/training regarding molecular-guided treatment3 (2–4)15 (28.8)
Limited local clinical guidelines3 (2–4)20 (38.5)
Limited patient understanding or acceptance of molecular testing4 (3–4)28 (53.8)