Horizon Scanning in Cancer Genomics: How Advances in Genomic Medicine Will Change Cancer Care Over the Next Decade

The Cost Effectiveness of Genomic Medicine in Cancer Control: A Systematic Literature Review

BACKGROUND AND OBJECTIVE

Genomic medicine offers an unprecedented opportunity to improve cancer outcomes through prevention, early detection and precision therapy. Health policy makers worldwide are developing strategies to embed genomic medicine in routine cancer care. Successful translation of genomic medicine, however, remains slow. This systematic review aims to identify and synthesise published evidence on the cost effectiveness of genomic medicine in cancer control. The insights could support efforts to accelerate access to cost-effective applications of human genomics.

METHODS

The study protocol was registered with PROSPERO (CRD42024480842), and the review was conducted in line with Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) Guidelines. The search was run in four databases: MEDLINE, Embase, CINAHL and EconLit. Full economic evaluations of genomic technologies at any stage of cancer care, and published after 2018 and in English, were included for data extraction.

RESULTS

The review identified 137 articles that met the inclusion criteria. Most economic evaluations focused on the prevention and early detection stage (n = 44; 32%), the treatment stage (n = 36; 26%), and managing relapsed, refractory or progressive disease (n = 51, 37%). Convergent cost-effectiveness evidence was identified for the prevention and early detection of breast and ovarian cancer, and for colorectal and endometrial cancers. For cancer treatment, the use of genomic testing for guiding therapy was highly likely to be cost effective for breast and blood cancers. Studies reported that genomic medicine was cost effective for advanced and metastatic non-small cell lung cancer. There was insufficient or mixed evidence regarding the cost effectiveness of genomic medicine in the management of other cancers.

CONCLUSIONS

This review mapped out the cost-effectiveness evidence of genomic medicine across the cancer care continuum. Gaps in the literature mean that potentially cost-effective uses of genomic medicine in cancer control, for example rare cancers or cancers of unknown primary, may be being overlooked. Evidence on the value of information and budget impact are critical, and advancements in methods to include distributional effects, system capacity and consumer preferences will be valuable. Expanding the current cost-effectiveness evidence base is essential to enable the sustainable and equitable translation of genomic medicine.

Revolutionizing healthcare and medicine: The impact of modern technologies for a healthier future-A comprehensive review

The increasing integration of new technologies is driving a fundamental revolution in the healthcare sector. Developments in artificial intelligence (AI), machine learning, and big data analytics have completely transformed the diagnosis, treatment, and care of patients. AI-powered solutions are enhancing the efficiency and accuracy of healthcare delivery by demonstrating exceptional skills in personalized medicine, early disease detection, and predictive analytics. Furthermore, telemedicine and remote patient monitoring systems have overcome geographical constraints, offering easy and accessible healthcare services, particularly in underserved areas. Wearable technology, the Internet of Medical Things, and sensor technologies have empowered individuals to take an active role in tracking and managing their health. These devices facilitate real-time data collection, enabling preventive and personalized care. Additionally, the development of 3D printing technology has revolutionized the medical field by enabling the production of customized prosthetics, implants, and anatomical models, significantly impacting surgical planning and treatment strategies. Accepting these advancements holds the potential to create a more patient-centered, efficient healthcare system that emphasizes individualized care, preventive care, and better overall health outcomes. This review's novelty lies in exploring how these technologies are radically transforming the healthcare industry, paving the way for a more personalized and effective healthcare for all. It highlights the capacity of modern technology to revolutionize healthcare delivery by addressing long-standing challenges and improving health outcomes. Although the approval and use of digital technology and advanced data analysis face scientific and regulatory obstacles, they have the potential for transforming translational research. as these technologies continue to evolve, they are poised to significantly alter the healthcare environment, offering a more sustainable, efficient, and accessible healthcare ecosystem for future generations. Innovation across multiple fronts will shape the future of advanced healthcare technology, revolutionizing the provision of healthcare, enhancing patient outcomes, and equipping both patients and healthcare professionals with the tools to make better decisions and receive personalized treatment. As these technologies continue to develop and become integrated into standard healthcare practices, the future of healthcare will probably be more accessible, effective, and efficient than ever before.

Canadian nursing and genomics: An engagement initiative

Advances in genome sequencing technologies and biomarker discoveries now inform individual risk assessments and treatment decision-making within cancer care. These advances have contributed to the emergence of precision healthcare where disease prevention and treatment recommendations are based upon individual genetic variability, as well as environmental and lifestyle considerations. To actively participate in precision healthcare and support patients, oncology nurses require specific knowledge and skills in cancer genomics. Nurses are poised to contribute to the safe and equitable delivery of precision healthcare and further education and engagement will support this endeavour. The Canadian Nursing and Genomics (CNG) promotes collaboration between nurses from the five domains of practice, from different healthcare sectors and educational backgrounds, as a key strategy to prepare nurses for the genomics era. This article provides a case study to illustrate genomics informed nursing practice across clinical settings and provides leadership strategies across the domains of nursing practice to support genomic literacy within nursing practice.

Soins infirmiers et génomique au Canada : un exemple de mobilisation

Les progrès de la technologie du séquençage génomique et la découverte de biomarqueurs jouent désormais un rôle dans l’évaluation du risque de cancer d’une personne et les décisions en matière de traitement. Ces progrès ont contribué à l’émergence de soins de santé de précision pour lesquels les recommandations relatives à la prévention et au traitement de la maladie se fondent sur la variabilité génétique individuelle, les facteurs environnementaux et le mode de vie. Pour jouer un rôle actif dans la prestation de soins de santé de précision et soutenir les patients dans ce nouvel univers, les infirmières en oncologie doivent posséder des connaissances particulières en génomique du cancer. Elles sont disposées à contribuer à la prestation de soins de santé sûrs et équitables; une formation et une mobilisation plus poussées permettront de soutenir cette démarche. Le projet Soins infirmiers et génomique au Canada veut promouvoir la collaboration entre les infirmières de cinq domaines de pratique, de divers secteurs de soins de santé et ayant des formations différentes, de façon à les préparer à entrer dans l’ère de la génomique. On présente ici une étude de cas qui illustre la pratique infirmière fondée sur la génomique en milieu clinique avant de proposer des stratégies de leadership à suivre dans les divers domaines de la pratique infirmière pour soutenir la littératie génomique dans la pratique infirmière.

Utilizing Genomically Targeted Molecular Data to Improve Patient-Specific Outcomes in Autism Spectrum Disorder

Molecular biology combined with genomics can be a powerful tool for developing potential intervention strategies for improving outcomes in children with autism spectrum disorders (ASD). Monogenic etiologies rarely cause autism. Instead, ASD is more frequently due to many polygenic contributing factors interacting with each other, combined with the epigenetic effects of diet, lifestyle, and environment. One limitation of genomics has been identifying ways of responding to each identified gene variant to translate the information to something clinically useful. This paper will illustrate how understanding the function of a gene and the effects of a reported variant on a molecular level can be used to develop actionable and targeted potential interventions for a gene variant or combinations of variants. For illustrative purposes, this communication highlights a specific genomic variant, SHANK3. The steps involved in developing molecularly genomically targeted actionable interventions will be demonstrated. Cases will be shared to support the efficacy of this strategy and to show how clinicians utilized these targeted interventions to improve ASD-related symptoms significantly. The presented approach demonstrates the utility of genomics as a part of clinical decision-making.