Emily Powell, PhD, ACRP-CP, senior scientist, Precision Genomics program, Parkview Mirro Center for Research & Innovation, provides an overview of the Precision Genomics program and how its efforts impact patient care, paving the way for a more personalized approach to treatment.
What is precision genomics?
Precision genomics involves looking at patients' DNA and using that information to choose the best route of care. This may mean choosing the appropriate treatments and getting patients to the right screening programs. There are times throughout healthcare, especially in the course of a cancer patient's journey, when it becomes important to choose the right treatment and to know when to give that treatment. We know that chemotherapy works for some patients and not for others. We also know the DNA mutations within a tumor can change over time. This may mean that some medicines work at some times but not others. Knowing the DNA status and how it changes throughout the course of disease progression can help us to choose the right treatments at the right time.
Getting the right treatment for the right patient involves examining those DNA mutations. We do this by taking DNA from the tumor and then sequencing it. We put the DNA onto a machine that reads the molecular code, which allows us to determine whether DNA changes have occurred within that tumor. If we find DNA changes, we may be able to use specific medicines that will work to shrink the tumor. This way, we can tailor treatments that are unique to an individual patient’s DNA code and give them at the right time.
How does precision genomics integrate with other medical specialties?
In addition to looking at the DNA found in a cancer patient's tumor, we can also look at what mutations any patient might have inherited. For example, if a patient inherits a mutation that puts them at risk for developing cancer, we can suggest earlier screenings such as mammograms or colonoscopies. In a similar way, some mutations might predispose a patient to developing heart disease. For example, if a patient inherits a mutation that might put them at increased risk for long QT syndrome. In that case, we can suggest that the patient receive annual echocardiograms so that we can catch those conditions sooner. Bringing this all together, if a patient is at risk for heart disease and also eventually develops cancer, we can choose medications that may shrink the cancer without harming the heart.
How does the Precision Genomics program hope to contribute to improved patient outcomes?
The field of Precision Genomics is very new. The Precision Genomics program within Parkview has only existed for a couple of years and is one of the only programs in the country that exists in the community hospital setting. One of the current goals of the program is to start collecting genomic data and determine whether we are increasing genomic testing rates and whether more testing is associated with improved patient outcomes. The goal of the program is to improve patient outcomes by providing scientific support to clinicians.
In many cases, when providers order these tests, they'll receive a report that includes multiple DNA mutations in the results. his report could also suggest many different therapy options for treating that patient. When this occurs, the Precision Genomics team can analyze those results and help select the best therapy options. Sometimes, the best therapy is unclear, and additional research is needed. In these situations, the Precision Genomics team can supply additional data that reflects how others in a similar patient population responded to a medication. Additionally, because we know some of these mutations can interact with each other, we can recommend one therapy that may be more effective than another.
What is the benefit of educational sessions for healthcare providers?
The field of genomics is changing rapidly and there's always new data and knowledge coming out about what these genes are doing in cancer or heart disease. It's important for providers to stay current on the literature and to learn what's coming out, but medical oncologists and other specialty practitioners are very busy with their patients in the clinic all day. It's unrealistic to expect them to be able to dedicate the time required to stay abreast of all of this knowledge, so the Precision Genomics team provides that support with ongoing education sessions. These sessions usually include a compilation of information from recent studies that we consolidate into 30-minute presentations that providers can attend during their lunch.
What benefit does having the Precision Genomics program at Parkview offer patients in the community?
These programs are extremely rare in the community hospital setting. For the most part, you'll only see genomics programs at large academic research institutions or other cancer institutes, so we're pretty fortunate to have one here. Access to this program at Parkview puts us in a unique position, both from a provider and a patient standpoint, especially as medicine moves toward a more individualized approach.
It gives our patients access to a higher level of care. Patients who receive these genome sequencing tests and the therapies based on them are thought to have better outcomes. Instead of treating all breast cancers like all breast cancers and all colon cancers like all colon cancers, if a breast cancer patient and a colon cancer patient happen to have the same DNA mutation, they might actually receive the same therapy.
My team also aims to consolidate all of the genomic sequencing test information into one place so that we get a comprehensive picture of a given patient's genomic landscape. This can be incredibly helpful for providers of patients within families carrying inheritable mutations or patients with coexisting chronic conditions. Then, we can make the most informed choices that span the entire spectrum of that patient's care.
Learn more
Learn more about the Precision Genomics program and the other impactful research being done at the Parkview Mirro Center for Research and Innovation by visiting our website.
