Changes in multi-gene cancer panels for children: A 4-year retrospective review.

The multi-gene panel is the most utilized genetic test to evaluate for germline cancer predisposition syndromes. However, the rate of change of commercial multigene panels is not well understood, and its value as a standalone test has also not been investigated. We conducted a retrospective chart review of the UPMC Children's Hospital of Pittsburgh Cancer Predisposition Program's genetic testing results to evaluate how multigene panels for pediatric and young adult patients with cancer have changed in size and scope from 2018 to 2022. We find that multigene panels show a trend of growing larger in number of genes included over time and explore the utility of additional genetic testing after the initial round of multi-gene panel testing. We demonstrate heterogeneity between commercial genetic testing laboratories and their panels over time, signifying a need for equity among genetic testing panels and vigilance among physicians and genetic counselors ordering panel-based testing.