Physicians at a community oncology clinic center have an increased understanding of the clinical utility of molecular testing after implementing next generation sequencing and precision medicine, said researchers.
In oncology, precision medicine is already well established with targeted therapies approved based on the patient’s genetic makeup or genetic variants of their tumor, and a combination of precision medicine, next generation sequencing (NGS), and diagnostics is making its way into community cancer clinics. A study published this weekend at the ASCO20 Virtual Scientific Program analyzed the results of NGS testing in a community cancer care clinic in coordination with a precision medicine program.
With the decreasing cost of NGS to identify both germline and somatic pathogenic variants and other technological advancements, there is a critical need for curation and interpretation of these results, the study authors noted, as clinicians often order the tests simultaneously.
The retrospective review examined germline NGS results from patients who were seen by the Hereditary Cancer Program at Hoag Family Cancer Institute in Newport Beach, California, since 2001. Researchers also compared those who had both positive genetic testing results and had tumor molecular profiling.
The cancer program saw a total of 8239 patients; of those, 6100 had germline testing done, and approximately 50% had multigene panel testing (MGPT).
Results showed that 15% of the patients with germline testing had a pathogenic or likely pathogenic mutation. Of those with the positive results, 71% were breast and ovarian cancer while 29% were other cancer types.
The researchers also analyzed NGS results for 713 tumors tested through a commercial laboratory in 1 year. All cases were subjected to the authors’ secondary annotation. That analysis resulted in additional recommendations in 40% of cases, beyond what was in the commercial report. The secondary annotations also provided additional clinical trial options in 30% of cases.
The cancer clinic had also begun a new program in the past year that led to the researchers examining tumor profiling results for indications of possible germline mutations. By analyzing those results, the authors said they made recommendations for genetic counseling in 91 (12.8%) cases.
The results show the importance of genetic counseling and MGPT in a community setting in patients with personal and/or family history of cancer, the authors wrote.
Physicians at the center have an increased understanding of the clinical utility of molecular testing, which benefits patients, the authors said.
Darabi S, Braxton DR, Homer J, et al. Precision medicine, genetics and genomics in a community cancer clinic. Presented at: Presented at: ASCO20 Virtual Scientific Program; Alexandria, VA: May 29-21, 2020. Abstract e13511.