Increasing data on variant penetrance, decreasing cost of testing, and inclusion of pharmacogenomic testing in guidelines (as with UGT1A1 variants) offer practical reasons that pharmacogenomics can and should expand germline relevance in cancer care.27 The significant association with increased patient accrual we observed among trials that use germline eligibility criteria is encouraging for the prospect of expanding germline-associated studies. The gene discussed is UGT1A1; the disease is cancer.