Tuesday, December 8, 2015

Bringing Genomics into the Clinic: Explaining Complex Issues

Genomeweb's Turna Ray has written a detailed article on the pathway from genomics discovery and genomics laboratory to the clinic.  It's mixed news, in that things seem to be getting better, but there's still much to be done.  The article is online here (subscription).

Just a couple years ago, Boehringer Ingelheim conducted a survey suggested that only 50% of lung cancer patients were getting basic genomic testing, like EGFR.  In a new survey, that number had risen to 81%.  However, due to delays in genomic test results, a significant proportion of patients are already started on non-precision chemotherapy even before their tests are back.

A public policy effort called "Don't Guess, Test" aims to raise the odds that precision genomics information will impact patient care for lung cancer patients.  It's backed by 17 organizations ranging from American Lung Association to Foundation Medicine.

Other disease advocacy groups are pursuing the same goals, for example, the Pancreatic Cancer Action Network or PANCAN (here).  PANCAN has an active and effective "Know Your Tumor" program that is raising the proportion of genomically tested cases.  I had the chance to meet some of the leadership of PANCAN last spring and their commitment to genomic medicine was impressive.

The Genomeweb article also discusses the level of patient education and physician education required to use genomic results effectively in the community.   For that, digital health and telemedicine/telehealth may be important mediators of the "last mile" in a journey that begins with the tumor biopsy, passes through the genomics and bioinformatics labs, and ends with effective clinical decisions.  Genomics companies like Caris and Foundation Medicine are establishing closer networks or alliances with key hospitals to facilitate this information flow, and a startup called Massive Bio is providing online access to tumor profiling experts and virtual tumor boards (home page here; business model here).