Improving Cancer Treatment, Patient Outcomes with Genomic Testing

New York University (NYU) is using a new kind of genomic testing to improve cancer treatment and patient outcomes.

Cancer has proven to be difficult to manage for patients and healthcare providers. From diagnosis to treatment, the disease presents many obstacles and complications. According to the Centers for Disease Control and Prevention (CDC), cancer was the second leading cause of death in the United States in 2019, resulting in nearly 600,000 deaths.

The genome profiling test is the creation of Matija Snuderl, MD, Director of Molecular Pathology and Diagnostics in the Department of Pathology at NYU Langone.

According to Snuderl, the NYU leadership team decided a few years ago to develop a next-generation sequencing test for cancer patients. The NYU Langone Genome Profiling of Actionable Cancer Targets (PACT) can find changes in the DNA code of 607 genes linked by previous studies to the development of multiple cancer types

Improving the industry standard, the PACT test can also identify the impacted genes and match them to Food and Drug Administration (FDA) approved drugs for treatment.

“The number one purpose was to improve the clinical care of patients with cancer, to be able to better choose therapies, to be able to better manage their care, and to be able to deal with a quickly increasing number of targeted therapies that target specific mutations,” Snuderl told HealthITAnalytics.

The test works by comparing tumor and normal tissue to discover somatic mutations. Additionally, with predictive analytics, the test can determine which therapies are the best options for individual patients.

“If you took the tumor alone and you sequenced it, there may be some variants that are, due to different ethnicities, different backgrounds, somebody that’s not cancer-related, but it can select skewing view of cancer. This way, you have very clear information regarding what happened in cancer cells themselves, and then you can have a much better way to navigate the decision-making for clinical care,” Snuderl said.

The genome sequencing tool allows NYU to take better care of their patients and guide their treatment options. Additionally, the test assists in developing an understanding of care management, efficiency, and how to decrease healthcare costs for both the patient and the provider.

Since everyone’s body is different, it can be challenging to determine which therapies will be the most effective in treating chronic disease. Therefore, ensuring that patients are receiving the correct treatment for their condition is critical. With the PACT test, providers can quickly determine the best course of action for the patients.

“If you give radiation to somebody who doesn’t need it, not only that you’re damaging them with unnecessary radiation, but you’re also spending healthcare dollars that are not necessary. Having more information about the biology of cancer helps you properly manage the care of patients. It’s for their benefit as well for the benefit of the healthcare system,” Snuderl said.

Recently, the PACT test received FDA approval. However, Snuderl pointed out that most laboratory-developed tests are not FDA approved as they do not fall under the federal agency’s jurisdiction.

“We get often asked, ‘Why did we even bother and why bring that pain on ourselves to go through the whole FDA process?’ The reason was that the ability to perform next-generation sequencing has become ubiquitous. Anybody who can buy a sequencer and buy off-the-shelf reagents can start sequencing cancer, but it doesn’t mean that it’s done right,” Snuderl said.

Not every state has the same regulatory environment, meaning not every test is at the quality one would expect. By obtaining FDA approval, Snuderl said it ensured that the team was providing the best quality test and patients were receiving the highest quality of care.

As for what a test like this could mean for the future of precision medicine, Snuderal said there is a long way to go. Currently, most patients with cancer do one receive any kind of next-generation sequencing for their cancer.

“It’s important to increase the number of properly clinically validated tests to make sure that as many people as possible get their cancer sequenced, they get proper therapy, and then we also get as much data as possible for better research, for better understanding,” Snuderl said.