Development of a Center for Personalized Cancer Care at a Regional Cancer Center: Feasibility Trial of an Institutional Tumor Sequencing Advisory Board.
Next-generation sequencing (NGS) capabilities can affect therapeutic decisions in patients with complex, advanced, or refractory cancer. We report the feasibility of a tumor sequencing advisory board at a regional cancer center. Specimens were analyzed for approximately 2800 mutations in 50 genes. Outcomes of interest included tumor sequencing advisory board function and processes, timely discussion of results, and proportion of reports having potentially actionable mutations. NGS results were successfully generated for 15 patients, with median time from tissue processing to reporting of 11.6 days (range, 5 to 21 days), and presented at a biweekly multidisciplinary tumor sequencing advisory board. Attendance averaged 19 participants (range, 12 to 24) at 20 days after patient enrollment (range, 10 to 30 days). Twenty-seven (range, 1 to 4 per patient) potentially actionable mutations were detected in 11 of 15 patients: TP53 (n = 6), KRAS (n = 4), MET (n = 3), APC (n = 3), CDKN2A (n = 2), PTEN (n = 2), PIK3CA, FLT3, NRAS, VHL, BRAF, SMAD4, and ATM. The Hotspot Panel is now offered as a clinically available test at our institution. NGS results can be obtained by in-house high-throughput sequencing and reviewed in a multidisciplinary tumor sequencing advisory board in a clinically relevant manner. The essential components of a center for personalized cancer care can support clinical decisions outside the university.
Spectrum Health Cancer Center, Spectrum Health System, Grand Rapids, Michigan; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, Michigan; Center for Cancer and Cell Biology, Van Andel Research Institute, Grand Rapids, Michigan; Division of Urology, Spectrum Health System, Grand Rapids, Michigan. Electronic address: brian.lane@spectrumhealth.org.
Brian R
BR
Lane
Advanced Technology Laboratory, Molecular Diagnostics, Spectrum Health System, Grand Rapids, Michigan.
Jeffrey
J
Bissonnette
Office of Clinical Research Operations, Spectrum Health System, Grand Rapids, Michigan.
Tracy
T
Waldherr
Office of Clinical Research Operations, Spectrum Health System, Grand Rapids, Michigan.
Deborah
D
Ritz-Holland
Spectrum Health Universal Biorepository, Spectrum Health System, Grand Rapids, Michigan.
Dave
D
Chesla
Spectrum Health Cancer Center, Spectrum Health System, Grand Rapids, Michigan; Spectrum Health Universal Biorepository, Spectrum Health System, Grand Rapids, Michigan; Department of Pathology, Spectrum Health System, Grand Rapids, Michigan.
Sandra L
SL
Cottingham
Advanced Technology Laboratory, Molecular Diagnostics, Spectrum Health System, Grand Rapids, Michigan.
Sheryl
S
Alberta
Advanced Technology Laboratory, Molecular Diagnostics, Spectrum Health System, Grand Rapids, Michigan.
Cong
C
Liu
Advanced Technology Laboratory, Molecular Diagnostics, Spectrum Health System, Grand Rapids, Michigan.
Amanda B
AB
Thompson
Center for Cancer and Cell Biology, Van Andel Research Institute, Grand Rapids, Michigan.
Carrie
C
Graveel
Center for Cancer and Cell Biology, Van Andel Research Institute, Grand Rapids, Michigan.
Jeffrey P
JP
MacKeigan
Spectrum Health Cancer Center, Spectrum Health System, Grand Rapids, Michigan; Division of Urology, Spectrum Health System, Grand Rapids, Michigan.
Sabrina L
SL
Noyes
Spectrum Health Cancer Center, Spectrum Health System, Grand Rapids, Michigan; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, Michigan; Department of Oncology, Spectrum Health System, Grand Rapids, Michigan.
Judy
J
Smith
Spectrum Health Cancer Center, Spectrum Health System, Grand Rapids, Michigan; Department of Hematology/Oncology, Cancer and Hematology Centers of West Michigan, Grand Rapids, Michigan.
Nehal
N
Lakhani
Spectrum Health Cancer Center, Spectrum Health System, Grand Rapids, Michigan; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, Michigan; Center for Cancer and Cell Biology, Van Andel Research Institute, Grand Rapids, Michigan; Department of Orthopaedic Oncology, Spectrum Health System, Grand Rapids, Michigan.
Matthew R
MR
Steensma
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059014:High-Throughput Nucleotide Sequencing / Q000379:methods; D006801:Humans; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D009369:Neoplasms / Q000235:genetics*; D057285:Precision Medicine / Q000379:methods