Precision Medicine in Oncology
Tumor Genetic Testing
Precision Oncology Team
TriHealth Cancer Institute Precision Oncology team includes Medical Oncologists, Nurses, Genetic Counselors, Clinical Research, Genetic Specialty Lab Coordinator, Pathologists, Surgeons, and Laboratory partners. The team can help recommend genetic testing, review genetic lab results, ensure an accurate diagnosis, identify the best treatment plan, deliver treatments at our patient-centered infusion centers, and coordinate advanced care with seamless communication between physicians and medical teams.
Providing cancer care down to the DNA level is one of the reasons TriHealth earned the Outstanding Achievement Award from the Commission on Cancer, becoming part of an elite group – only 14 percent of health systems in the U.S. achieve this accreditation. We offer all the clinical and foundational services needed to support our patients on their personal cancer journey.
Why Tumor Testing?
If you have a cancer diagnosis, you are seeking world-class care close to home. No two cancers are the same. Our compassionate oncologists go beyond routine cancer treatment by using the latest technology in tumor genetic testing to select the right treatment plan for you. Tumor genetic analysis gives a physician improved ability to predict which treatments will work best for specific patients and which treatments could be ineffective. This insight allows you to start the best therapy sooner. Every patient evaluated for cancer treatment at TriHealth Cancer Institute is considered for genetic testing of their tumor.
What is precision medicine in cancer care?
Precision medicine has also been called individualized medicine or personalized medicine. The concept of precision medicine is that physicians use information about a person’s genetic makeup and the genetic mutations found in their cancer to determine the best plan for cancer prevention, diagnosis and treatment. Before personalized medicine, most patients with a specific type and stage of cancer received the same treatment. Over the last decade, science has come to understand that each individual patient’s cancer is different and unique. This has allowed for the development of new treatments that specifically target a patient’s unique form of cancer.
In general, people are about 99.9% genetically the same, but when a cancer develops, new genetic changes occur within the cancer cells. The changes, called “mutations” are unique changes in the cancer cell DNA leading to variations in how the tumor cells responds to treatment. Most genetic mutations in cancer accumulate over a person’s lifetime—these are called acquired or “somatic” genetic changes. Somatic mutations are not inherited.
How is tumor genetic testing performed?
There are several ways to obtain a tumor DNA sample. A tissue sample from biopsy or surgery can be sent to the lab for testing. Some tumors will shed tumor DNA into the blood stream. Therefore, a blood sample can also be collected for analysis.
The lab performs testing on the tumor DNA and identifies gene mutations specific to your tumor among 600+ genes analyzed in a single test. A report is generated and sent to the Precision Oncology team with recommendations for treatment specifically targeted to your tumor. This opens treatment options beyond the traditional.
For example, tumor testing can identify patients for Immunotherapy. Immunotherapy is a groundbreaking treatment that harnesses a person’s own immune system to fight cancer. Our experienced team routinely tests patients for biomarkers that determine whether Immunotherapy would be an effective treatment. Genetic tumor results may show Immunotherapy as an alternative to traditional chemotherapy. Tumor testing can also help to monitor your response to therapy over time and identify the need to change therapy.
The results of these tests may help to:
- Match patients with personalized treatments that are more likely to be effective and cause fewer side effects
- Help us learn more about the origin of your cancer
- Match patients with clinical trials
- Predict the risk of recurrence, which is the return of cancer, over time
What’s Next? Multi-Disciplinary Team
As part of the tumor profiling, every patient is also considered for clinical trials, inherited genetic testing, and Molecular Tumor Board review.
Matching Patients to Clinical Trials Based on Genetic Information
A genetic test may reveal that a patient is eligible for a clinical trial and may give additional treatment options for patients with advanced disease.
Genetic Risk Assessment and Counseling
Sometimes genetic mutations seen in the tumor testing can be inherited. This means that future generations might also be at higher risk for cancer. Genetic Counselors review every tumor profile report for signs that tumor mutations might also be inherited. For example, if there is a mutation in a gene like BRCA2, family members could be at increased risk for breast, ovarian, prostate, pancreas cancers and melanoma. Mutations on tumor profiling are flagged and the Genetic Counselor will reach out to the patient, to offer family testing.
Click here for more information about Cancer Genetic Counseling at TriHealth.
Molecular Tumor Board
A group of clinical experts and oncology scientists meets regularly to review tumor profiling test results and to make therapy recommendations. Every TriHealth Cancer Institute patient can be considered for review and benefit from a multidisciplinary team’s input.
Huelsman, K. M., Basil, J. B., Sisson, R., Lipe, L. R., Mahon, B., & Draper, D. J. (2021). Somatic Tumor Profile Analysis in a Patient with Germline PMS2 Mutation and Synchronous Ovarian and Uterine Carcinomas. Journal of Personalized Medicine, 11(7). https://www.mdpi.com/1176942
Somatic Tumor Profile Analysis in a Patient with Germline PMS2 Mutation and Synchronous Ovarian and Uterine Carcinomas
Lynch syndrome patients with synchronous endometrial and ovarian cancer (SEOC) are rare. This case is an example of a patient with PMS2 germline Lynch syndrome with shared somatic variants that demonstrate clonality of the two tumors arising from one common site.