The Evolution and Clinical Impact of Diagnostic Testing - Episode 1

Evolution of Personalized Medicine

David C. Collymore, MD, MBA, believes the field of personalized medicine has seen tremendous developments over the last 5 to 10 years, especially in oncology care.

“The role of genetic testing in both screening and treatment has received a lot of publicity in oncology, particularly in breast cancer,” he said, adding that genetic testing has been integrated into clinical care for the diagnosis of breast cancer to detect specific mutations in tumors. Dr Collymore explained that although it’s not yet the standard of care in screening for cancer risk, individuals have taken it upon themselves to undergo genetic testing to determine their risk of developing cancer.

“Angelina Jolie, who had prophylactic surgery, is a prominent example of this,” Collymore said. He then narrated a personal story of an acquaintance who, being aware of a strong family presence of breast and ovarian cancer, underwent genetic testing herself, followed by prophylactic surgery.

While the field of oncology has seen a lot of advances with respect to screening and treatment based on genetic testing, Dr Collymore believes that other areas such as diabetes and hypertension have also found use for this tool.

In terms of the impact on outcomes, he referenced older studies with tamoxifen in the treatment of breast cancer. “They found that a significant proportion of patients did not respond to treatment [with tamoxifen], which was a major advancement. But there is still a lot of work left to be done to show that it is cost effective,” Dr Collymore said.