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Institute for Genomic Medicine Cancer Protocol Blends Research and Clinical Genomics

Institute aims for a comprehensive genome analysis for every cancer patient.

Building on their experience contributing to The Cancer Genome Atlas (TCGA), the PanCancer Atlas and other cancer and genomic research efforts, leaders of the Institute for Genomic Medicine at Nationwide Children’s are “working hard to blur the line between basic research and clinical genomics,” says Richard Wilson, PhD, institute executive director.

“We designed our Cancer Protocol to better understand the genomics of the patient’s tumor and to have a means to make some genomics studies available to patients prior to them being fully reimbursed or available on a clinical basis,” says Julie Gastier-Foster, PhD, senior director of the Institute for Genomic Medicine Clinical Laboratory.

Under the protocol, a team of institute members reviews patient nominations for genomic profiling submitted by hospital oncologists. Most nominees have tumors that did not respond to therapy or that came back after remission. Selected patients are invited to consent to have a full genomic analysis performed.

“We look at both tumor and normal cells for all patients and do a thorough comparison across all known human genes,” says Elaine Mardis, PhD, co-executive director of the Institute for Genomic Medicine. “We look for susceptibility genes for their cancer risk by studying normal cells, and we look across the entire cancer genome plus their RNA for clues to what might be driving their cancer.”

“We want to get to the point where a comprehensive genome analysis is available to every patient that comes here with a cancer diagnosis.” – Richard Wilson, PhD

The team identifies potential clinically important findings. If clinical testing validates the findings, the relevant clinical information can be recorded in the medical record and, ideally, may identify alternative treatment options or offer a clue to outcomes.

The more results the team validates and links to relevant clinical interpretations, the closer it gets to offering full genomic analysis as a clinical test. Institute leadership anticipate having some options approved for insurance reimbursement as soon as the end of 2018.

The Institute for Genomic Medicine is working the make the analysis quicker and cheaper and help physicians understand what to do with it, Dr. Wilson says. “We want to get to the point where a comprehensive genome analysis is available to every patient that comes here with a cancer diagnosis.

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