Entering the consumer genome era

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In the President's address yesterday evening at AACR (American Association for Cancer Research) annual meeting, Judy Garber, MD, of Dana-Farber Cancer Institute, spoke on "Cancer Genetics in the Post-Genome Era." Garber is the director of the Center for Cancer Genetics and Prevention at DFCI.One of the points she drove home was the fact that it is getting easier and cheaper (relatively speaking) to have your whole genome sequenced. While this may cost upwards of $10,000 to $20,000, individuals are doing it. And with the ease of consumer genetic tests for individual genes, it may gain traction, and it will only get cheaper. The technique is used to generate an entire DNA code for one person, comprising about 3 billion letters of DNA sequence, which includes about 3 million genetic variants. Geneticists examine this genetic information with what's known on health and disease. This analysis can help identify health conditions the patient may have an increased risk for, or have already. Using that information can help physicians create an individualized plan for treatment or prevention.Garber noted that Brigham and Women's Hospital has foreseen the day where patients bring in their sequenced genome to their doctor and ask for an interpretation. Because while the sequencing may be easy, the analysis is what will be difficult. Brigham and Women's Hospital has opened the Adult Genetics Clinic and Personal Genomic Consultation Service along with Partners HealthCare Center for Personalized Genetics Medicine. The service is a pilot project that will offer whole genome sequencing to patients who would have the greatest short-term benefit from the testing, looking for traits that would impact treatment or prevention strategies.[You can read more about genome sequencing in "It's In the Genes."]Patients would be referred by their physician for the pilot program, but Garber foresees the day when someone arrives at their doctor's appointment bringing in a flash drive of their genome sequencing and asks "Now what?"So, would you get your genome sequenced today? And does a history of cancer make one more amenable to the idea?

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For patients with cancer, the ongoing chemotherapy shortage may cause some anxiety as they wonder how they will receive their drugs. However, measuring drugs “down to the minutiae of the milligrams” helped patients receive the drugs they needed, said Alison Tray. Tray is an advanced oncology certified nurse practitioner and current vice president of ambulatory operations at Rutgers Cancer Institute in New Jersey.  If patients are concerned about getting their cancer drugs, Tray noted that having “an open conversation” between patients and providers is key.  “As a provider and a nurse myself, having that conversation, that reassurance and sharing the information is a two-way conversation,” she said. “So just knowing that we're taking care of you, we're going to make sure that you receive the care that you need is the key takeaway.” In June 2023, many patients were unable to receive certain chemotherapy drugs, such as carboplatin and cisplatin because of an ongoing shortage. By October 2023, experts saw an improvement, although the “ongoing crisis” remained.  READ MORE: Patients With Lung Cancer Face Unmet Needs During Drug Shortages “We’re really proud of the work that we could do and achieve that through a critical drug shortage,” Tray said. “None of our patients missed a dose of chemotherapy and we were able to provide that for them.” Tray sat down with CURE® during the 49th Annual Oncology Nursing Society Annual Congress to discuss the ongoing chemo shortage and how patients and care teams approached these challenges. Transcript: Particularly at Hartford HealthCare, when we established this infrastructure, our goal was to make sure that every patient would get the treatment that they need and require, utilizing the data that we have from ASCO guidelines to ensure that we're getting the optimal high-quality standard of care in a timely fashion that we didn't have to delay therapies. So, we were able to do that by going down to the minutiae of the milligrams on hand, particularly when we had a lot of critical drug shortages. So it was really creating that process to really ensure that every patient would get the treatment that they needed. For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.
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