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Melas M, Subbiah S, Saadat S, Rajurkar S, McDonnell KJ. The Community Oncology and Academic Medical Center Alliance in the Age of Precision Medicine: Cancer Genetics and Genomics Considerations. J Clin Med 2020; 9:E2125. [PMID: 32640668 PMCID: PMC7408957 DOI: 10.3390/jcm9072125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 06/28/2020] [Accepted: 07/02/2020] [Indexed: 12/15/2022] Open
Abstract
Recent public policy, governmental regulatory and economic trends have motivated the establishment and deepening of community health and academic medical center alliances. Accordingly, community oncology practices now deliver a significant portion of their oncology care in association with academic cancer centers. In the age of precision medicine, this alliance has acquired critical importance; novel advances in nucleic acid sequencing, the generation and analysis of immense data sets, the changing clinical landscape of hereditary cancer predisposition and ongoing discovery of novel, targeted therapies challenge community-based oncologists to deliver molecularly-informed health care. The active engagement of community oncology practices with academic partners helps with meeting these challenges; community/academic alliances result in improved cancer patient care and provider efficacy. Here, we review the community oncology and academic medical center alliance. We examine how practitioners may leverage academic center precision medicine-based cancer genetics and genomics programs to advance their patients' needs. We highlight a number of project initiatives at the City of Hope Comprehensive Cancer Center that seek to optimize community oncology and academic cancer center precision medicine interactions.
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Affiliation(s)
- Marilena Melas
- The Steve and Cindy Rasmussen Institute for Genomic Medicine, Nationwide Children’s Hospital, Columbus, OH 43205, USA;
| | - Shanmuga Subbiah
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Glendora, CA 91741, USA;
| | - Siamak Saadat
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Colton, CA 92324, USA;
| | - Swapnil Rajurkar
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Upland, CA 91786, USA;
| | - Kevin J. McDonnell
- Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA 91010, USA
- Center for Precision Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA 91010, USA
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Lane BR, Bissonnette J, Waldherr T, Ritz-Holland D, Chesla D, Cottingham SL, Alberta S, Liu C, Thompson AB, Graveel C, MacKeigan JP, Noyes SL, Smith J, Lakhani N, Steensma MR. Development of a Center for Personalized Cancer Care at a Regional Cancer Center: Feasibility Trial of an Institutional Tumor Sequencing Advisory Board. J Mol Diagn 2015; 17:695-704. [PMID: 26331835 DOI: 10.1016/j.jmoldx.2015.07.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 06/17/2015] [Accepted: 07/01/2015] [Indexed: 11/19/2022] Open
Abstract
Next-generation sequencing (NGS) capabilities can affect therapeutic decisions in patients with complex, advanced, or refractory cancer. We report the feasibility of a tumor sequencing advisory board at a regional cancer center. Specimens were analyzed for approximately 2800 mutations in 50 genes. Outcomes of interest included tumor sequencing advisory board function and processes, timely discussion of results, and proportion of reports having potentially actionable mutations. NGS results were successfully generated for 15 patients, with median time from tissue processing to reporting of 11.6 days (range, 5 to 21 days), and presented at a biweekly multidisciplinary tumor sequencing advisory board. Attendance averaged 19 participants (range, 12 to 24) at 20 days after patient enrollment (range, 10 to 30 days). Twenty-seven (range, 1 to 4 per patient) potentially actionable mutations were detected in 11 of 15 patients: TP53 (n = 6), KRAS (n = 4), MET (n = 3), APC (n = 3), CDKN2A (n = 2), PTEN (n = 2), PIK3CA, FLT3, NRAS, VHL, BRAF, SMAD4, and ATM. The Hotspot Panel is now offered as a clinically available test at our institution. NGS results can be obtained by in-house high-throughput sequencing and reviewed in a multidisciplinary tumor sequencing advisory board in a clinically relevant manner. The essential components of a center for personalized cancer care can support clinical decisions outside the university.
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Affiliation(s)
- Brian R Lane
- Spectrum Health Cancer Center, Spectrum Health System, Grand Rapids, Michigan; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, Michigan; Center for Cancer and Cell Biology, Van Andel Research Institute, Grand Rapids, Michigan; Division of Urology, Spectrum Health System, Grand Rapids, Michigan.
| | - Jeffrey Bissonnette
- Advanced Technology Laboratory, Molecular Diagnostics, Spectrum Health System, Grand Rapids, Michigan
| | - Tracy Waldherr
- Office of Clinical Research Operations, Spectrum Health System, Grand Rapids, Michigan
| | - Deborah Ritz-Holland
- Office of Clinical Research Operations, Spectrum Health System, Grand Rapids, Michigan
| | - Dave Chesla
- Spectrum Health Universal Biorepository, Spectrum Health System, Grand Rapids, Michigan
| | - Sandra L Cottingham
- Spectrum Health Cancer Center, Spectrum Health System, Grand Rapids, Michigan; Spectrum Health Universal Biorepository, Spectrum Health System, Grand Rapids, Michigan; Department of Pathology, Spectrum Health System, Grand Rapids, Michigan
| | - Sheryl Alberta
- Advanced Technology Laboratory, Molecular Diagnostics, Spectrum Health System, Grand Rapids, Michigan
| | - Cong Liu
- Advanced Technology Laboratory, Molecular Diagnostics, Spectrum Health System, Grand Rapids, Michigan
| | - Amanda B Thompson
- Advanced Technology Laboratory, Molecular Diagnostics, Spectrum Health System, Grand Rapids, Michigan
| | - Carrie Graveel
- Center for Cancer and Cell Biology, Van Andel Research Institute, Grand Rapids, Michigan
| | - Jeffrey P MacKeigan
- Center for Cancer and Cell Biology, Van Andel Research Institute, Grand Rapids, Michigan
| | - Sabrina L Noyes
- Spectrum Health Cancer Center, Spectrum Health System, Grand Rapids, Michigan; Division of Urology, Spectrum Health System, Grand Rapids, Michigan
| | - Judy Smith
- Spectrum Health Cancer Center, Spectrum Health System, Grand Rapids, Michigan; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, Michigan; Department of Oncology, Spectrum Health System, Grand Rapids, Michigan
| | - Nehal Lakhani
- Spectrum Health Cancer Center, Spectrum Health System, Grand Rapids, Michigan; Department of Hematology/Oncology, Cancer and Hematology Centers of West Michigan, Grand Rapids, Michigan
| | - Matthew R Steensma
- Spectrum Health Cancer Center, Spectrum Health System, Grand Rapids, Michigan; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, Michigan; Center for Cancer and Cell Biology, Van Andel Research Institute, Grand Rapids, Michigan; Department of Orthopaedic Oncology, Spectrum Health System, Grand Rapids, Michigan
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