Decision Support for Genomically Informed Therapy
Genomic analysis of individual patients is now affordable and therapies targeted to specific molecular aberrations are being tested in clinical trials. However, even highly-specialized physicians at leading academic centers are not equipped to apply genomic information available in publicly available sources to clinical-decision-making concerning individual patients. Dr. Meric-Bernstam will describe informatics tools she and her team have developed to support personalized cancer treatment as "standard of care" rather than "one off" exceptions. These include: 1) a standardized approach for classification of variant actionability, 2) a database of therapeutic implications of common genomic aberrations using automated processing of publicly-available sources and 3) tools to summarize and present patient-specific annotations to clinicians. Efforts to implement these tools at a large comprehensive cancer center and beyond as well as approach to provider education in genomics and decision support tools will be reviewed.
Dr. Funda Meric-Bernstam is Chair of the Department of Investigational Cancer Therapeutics — the Phase I Program at MD Anderson Cancer Center, the Medical Director of the Institute for Personalized Cancer Therapy (IPCT), Professor in the Division of Cancer Medicine, and Professor in the Department of Breast Surgical Oncology. She has a basic and translational research program that is focused on molecular therapeutics, predominantly on PI3K/Akt/mTOR signaling, to delineate the mechanism of action of each agent targeting this pathway and the molecular alterations useful to prospectively identify patients who will benefit most from each agent, and optimal combination therapies.
As Medical Director of IPCT, she has not only led large efforts of genomic testing within the institution, but has a) helped build a framework for rapid assessment of actionability of genomic alterations; b) established a Precision Oncology Decision Support Team who can provide point of care input for actionability; c) launched the public website “www.personalizedcancertherapy.org” providing access to expert curation of information on therapeutic relevance of specific genes/variants; d) created databases and clinical trial alert systems to facilitate accrual to genotype-selected trials across the institution; and e) monitors trial enrollment after genomic testing to identify approaches to obstacles to trial enrollment. She has participated in, as well as led, investigator-initiated trials, cooperative group trials, and industry sponsored trials.