Evidence map›Paper›PMID 41995114›Full record

ArticleClinical and translational science2026

Analytical Validation of an Annotation Tool for WGS-Based Pharmacogenomics: Preparing for Clinical Implementation in Pediatric Oncology.

Meta H M Diekstra, Nienke Biesot, Julie Donders, Eugène T P Verwiel, Alex Janse, Alwin D R Huitema, Lidwien M Hanff, Bastiaan B J Tops, Patrick Kemmeren, Jayne Y Hehir-Kwa

Abstract readValidation Study
In one paragraph

Article in Clinical and translational science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Meta H M DiekstraPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID 0000-0002-9368-3650
Nienke BiesotPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Julie DondersPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Eugène T P VerwielPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID 0000-0001-9663-6780
Alex JansePrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID 0000-0002-7766-787X
Alwin D R HuitemaPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID 0000-0003-1939-4639
Lidwien M HanffPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID 0000-0003-1127-1589
Bastiaan B J TopsPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID 0000-0002-1699-8210
Patrick KemmerenPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID 0000-0003-2237-7354
Jayne Y Hehir-KwaPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.ORCID 0000-0003-0837-304X

Funding

Stichting Prinses Máxima Centrum Foundation 12.7
6 · The paper itself

Abstract

Whole genome sequencing (WGS) is increasingly accessible in clinical practice, enabling pharmacogenomics (PGx) integration, including in pediatric oncology. However, the lack of validated software to accurately annotate clinically actionable PGx variants from WGS limits routine implementation. We therefore aimed to identify and validate a PGx annotation tool suitable for clinical use in pediatric oncology. We evaluated several tools for technical performance and clinical integration. The Pharmacogenomics Clinical Annotation Tool (PharmCAT) was selected for its alignment with expert-reviewed PGx guidelines, inclusion of relevant gene-drug pairs and prescribing recommendations. PharmCAT was validated using an in silico dataset by introducing known diplotypes into the Genome in a Bottle (GIAB) reference sample, complemented by four clinically confirmed diplotypes from three patients. Diplotype and phenotype outputs from WGS were compared against the GIAB and patient reference data. We tested 71 diplotypes across seven genes (TPMT, NUDT15, CYP3A5, CYP2C9, CYP2C19, DPYD, UGT1A1), using ≥ 95% sensitivity and specificity as validation criteria. CYP2D6 was excluded from this validation due to genotyping limitations from the input data used by PharmCAT. The tool was integrated into our WGS analysis pipeline using containerization for consistent, reproducible execution. Diplotype and phenotype results from PharmCAT fully matched the in silico GIAB set and patient samples, achieving 100% sensitivity and specificity. These findings confirm PharmCAT as a reliable tool for preemptive PGx annotation, supporting implementation in pediatric oncology. Its clinical integration supports individualized dosing, reducing adverse effects and improving efficacy. Further validation of additional gene-drug pairs will broaden its clinical utility.

Indexed as

Antineoplastic AgentsMedical OncologyMolecular Sequence AnnotationNeoplasmsPharmacogeneticsPharmacogenomic TestingWhole Genome SequencingChildFemaleHumansPediatricsPharmacogenomic VariantsPhenotypeReproducibility of ResultsSoftwareAntineoplastic AgentsDNAoncologypediatricpharmacogenomicssoftware

Identifiers

PMID41995114
PMCPMC13088307

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.