DefinePK

Abstract

Background: Molecular biomarker testing has become a cornerstone of precision oncology, guiding targeted therapy and improving diagnostic accuracy. However, its integration into routine cancer care, particularly in low- and middle-income countries, remains suboptimal due to multifactorial challenges.
Objective: To explore the experiences, attitudes, and perceived barriers faced by oncology clinicians in implementing molecular biomarker testing in routine cancer care in Lahore, Pakistan.
Methods: A qualitative descriptive study was conducted over eight months in Lahore, utilizing purposive sampling to recruit 23 oncology clinicians from public and private tertiary care hospitals. Semi-structured, in-depth interviews were audio-recorded, transcribed, and analyzed using Braun and Clarke’s thematic analysis framework. Data saturation was achieved and NVivo software supported systematic coding.
Results: Five major themes emerged: clinical relevance and awareness, operational and logistical challenges, educational and training gaps, ethical and emotional dilemmas, and systemic and policy-driven barriers. Clinicians reported variability in biomarker knowledge, difficulties in interpreting results, infrastructure limitations, and lack of standardized protocols. Emotional strain in discussing ambiguous or unactionable results, and disparities in patient access due to financial constraints, were also prominent. Participants emphasized the need for clearer guidelines, institutional support, and continued medical education.
Conclusion: The study highlights the complex landscape surrounding biomarker testing adoption in oncology practice within a resource-limited setting. Addressing the identified barriers through systemic reform, clinician support, and targeted education can enhance the practical uptake of precision diagnostics, ultimately improving cancer care delivery in similar contexts.