Saint Luke's Cancer Institute, and Dr. Pluard is also with the University of Missouri-Kansas City, Kansas City, Missouri.
Co-Director of Thoracic Oncology, Inova Schar Cancer Institute, Fairfax, Virginia.
Mo Med. 2023 Jan-Feb;120(1):79-82.
Next generation sequencing (NGS) has become standard practice for identification and treatment of targetable driver mutations in advanced cancer. However, NGS interpretation of clinical applicability can be challenging to clinician, with potential impact on patient's outcome. Specialized precision medicine services are poised to bridge this gap by creating collaborative frameworks to formulate and deliver genomic patient care plans.
Saint Luke's Cancer Institute in Kansas City, Missouri, (SLCI) instituted the Center for Precision Oncology (CPO) in 2017. The program accepts patient referrals for a multidisciplinary molecular tumor board and offers CPO clinic visits. An Institutional Review Board-approved molecular registry was initiated. It catalogues genomic files along with patient demographics, treatment and outcomes. CPO patient volumes, recommendation acceptance, clinical trial matriculation and funding for drug procurement were closely tracked.
In 2020 there were 93 referrals to the CPO with 29 patient clinic visits. 20 patients matriculated to CPO-recommended therapies. Two patients were successfully enrolled in Expanded Access Programs (EAPs). CPO successfully procured eight off-label treatments. Treatments initiated per CPO recommendations totaled over $1 million in drug costs.
Precision medicine services are essential tool for oncology clinicians. In addition to expert NGS analysis interpretation, precision medicine programs provide crucial multidisciplinary support for patients to understand the implications of their genomic report and pursue targeted treatment as indicated. Molecular registries associated with these services offer valuable opportunities for research.
下一代测序（NGS）已成为识别和治疗晚期癌症中靶向驱动突变的标准方法。然而，NGS 对临床适用性的解读可能对临床医生具有挑战性，这可能对患者的预后产生影响。专门的精准医学服务有望通过创建协作框架来制定和提供基因组患者护理计划来弥补这一差距。
密苏里州堪萨斯城的圣卢克癌症研究所（SLCI）于 2017 年成立了精准肿瘤中心（CPO）。该计划接受多学科分子肿瘤委员会的患者转介，并提供 CPO 门诊就诊。启动了经机构审查委员会批准的分子登记处。它将基因组文件与患者人口统计学、治疗和结果一起进行编目。CPO 患者量、建议接受率、临床试验入学率以及药物采购资金都得到了密切跟踪。
2020 年，有 93 名患者向 CPO 转介，其中有 29 名患者进行了门诊就诊。20 名患者参加了 CPO 推荐的治疗。有两名患者成功参加了扩大准入计划（EAP）。CPO 成功采购了 8 种非标签治疗方法。根据 CPO 建议开始的治疗方法总共花费了超过 100 万美元的药物费用。
精准医学服务是肿瘤临床医生的重要工具。除了专家的 NGS 分析解读外，精准医学计划还为患者提供了至关重要的多学科支持，以了解他们的基因组报告的含义，并根据需要进行靶向治疗。与这些服务相关的分子登记处提供了有价值的研究机会。
