As genomic sequencing has become faster and less expensive, physicians have used this new technology to guide and manage care for patients with cancer. Genomic testing, also known as genomic profiling, was initially used for patients with advanced cancer when standard therapy failed. The goal of the testing was to identify unique genetic characteristics of a patient’s tumor that could be targeted with alternative therapies. Now, many more cancer patients have the potential to benefit from genomic testing. DNA testing, available through what’s known as next generation sequencing technology, is also being used to improve early detection of cancer, assess cancer risk, monitor response and detect recurrence.
In their paper Twenty-First Century Precision Medicine in Oncology: Genomic Profiling in Patients With Cancer in the October issue of Mayo Clinic Proceedings, authors Mitesh Borad, M.D., at Mayo Clinic, and Patricia LoRusso, D.O., at Yale University, provide an overview of how genomic profiling is being used in many areas of cancer care. They also highlight barriers to successful clinical implementation thus far and outline critical issues that must be addressed in future research efforts in order to advance the use of genomics to guide cancer care.
“Next generation sequencing has already enhanced our understanding of the genetic characteristics underlying cancer. To support use of this promising technology, future research efforts need to build clinical evidence to guide how next generation sequencing can most effectively be used to develop individualized approaches to cancer care,” says Dr. Borad.
Barriers to delivering targeted therapies to patients
For many patients with advanced cancer, clinical trials that include genomic testing offer the hope of finding an individualized treatment targeted at genetic characteristics of their cancer. According to the authors, only a small percentage of patients have benefited thus far from individualized therapies identified in these clinical studies.
The authors suggest that several factors may be contributing to the limited success of delivering targeted therapies using genomic profiling so far:
Critical issues for the next phase of precision cancer care
In order to build the rigorous evidence needed to support the use of genomic testing in clinical care for cancer, the authors suggest that physicians and scientists address these questions in future research:
Mayo Clinic Proceedings Symposium on Precision Medicine
This paper is the sixth in Mayo Clinic Proceedings Symposium on Precision Medicine, a series of articles that cover a wide range of topics in personalized medicine. Watch for upcoming articles in the symposium, which will focus on how personalized medicine and genomics are impacting patient care. Learn more about the series.
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