By Monica Heger
This story was originally published June 14.
The Fox Chase Cancer Center in Philadelphia will begin offering whole-exome and whole-transcriptome sequencing services this fall to cancer patients as part of an agreement the center recently inked with Life Technologies.
The new service will be offered through the Cancer Genome Institute at Fox Chase, also launching this fall, and will be offered in a CLIA-certified lab on Life Tech's SOLiD.
Jeff Boyd, the vice president of molecular medicine at Fox Chase, who will serve as the executive director of the Cancer Genome Institute, said that patients with advanced or recurrent disease will be the most likely candidates for the service.
The goal is to use sequencing to help identify drugs that could target patients' specific mutations and to rule out drugs that likely would not be effective.
"We're not limiting the service to a specific population other than those in need of therapeutic direction because they've failed the standard of care," Boyd told Clinical Sequencing News.
The service will be made available to any cancer patient, and clinically actionable results will be returned to the patient's physician who can then share the results with the patient and use them to help decide on the next course of treatment.
Currently, the team is in the process of establishing a CLIA-certified lab to do the exome and transcriptome sequencing.
They are currently sequencing banked tumor samples from patients who are already deceased in order to ensure that the process is smooth and to figure out what the turnaround time will be.
Boyd said they are aiming for a turnaround time of two weeks. "It's got to be quick, otherwise it won't be useful," Boyd said.
The service will be paid for by the patients themselves, and Boyd said that Fox Chase has not yet decided on a cost. Down the road, it could potentially be subject to reimbursement by insurance companies, but not initially.
Boyd expects that the service will begin modestly, with tens of patients, and could increase to hundreds of patients within a year or two. Eventually, he said he wouldn't be surprised if 2,000 to 3,000 patients per year used the service.
The service will likely follow initial treatment and standard-of-care therapy. It is unlikely that newly diagnosed patients would make use of it, except for those with rare tumor types, such as some sarcomas, or for tumors for which there is not a good standard-of-care treatment, like pancreatic and brain cancer, Boyd said.
Mutations of known significance will be returned to the oncologist in a report detailing not only the individual mutations, but functional information about the pathway and drugs that are known to target those mutations. Genetic counseling will also be provided. Mutations of unknown significance will not be returned, said Boyd, unless the mutation is located in a druggable target.
"The ideal result is a test result saying that these three drugs are potentially useful and these 10 drugs are definitely not," Boyd said. However, "it will probably be a pretty rare case that is open and shut, where a single drug would be the obvious target," he said.
The primary goal is to develop therapeutic options for patients. However, all of the information collected from the sequencing will be stored in a database, including the mutations of unknown significance, which could later be mined to yield further insight into the different tumor types or to develop better diagnostics or predict outcomes.
Additionally, with consent, the patient's anonymized genomic information, clinical outcome, and therapy recommendations will also be stored in the database and made available to the research and clinical oncology community at large.
The center is equipped with three SOLiD machines, and plans to eventually include the Ion Torrent PGM and other Life Technologies systems as they become available. "As Life Tech ramps up in terms of their third- and fourth-generation sequencers, we'll, as a partner, ramp up with them," Boyd said.
While the financial terms of the partnership with Life Tech are confidential, Boyd said that the company would be providing technical expertise, bioinformatics support, and marketing services, among other resources.
The company has a lot of resources, including "a whole suite of IT solutions that will be made available to us for interpreting the data," he said.
The launch of the sequencing services will coincide with the launch of the Cancer Genome Institute this fall, which will be located on the third floor of the recently opened Robert C. Young, MD, Pavilion at Fox Chase.
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