In the first part of the module, the author tackles the precision oncology promise and by delivering on this promise, underscores the need for integrated healthcare solutions and stops to artificially divide diagnostic testing from treatment planning and execution.
In the following part, the author elaborates on genomics testing and key elements that should be considered from the following aspects: access to quality ensured testing, the importance of having adequate expertise to act when getting the results, patient access to matched treatment, testing in terms of providing a standard-of-care treatment, if testing is informative to management and about screening for inclusion into clinical trials, all around a central question on what information the oncologist can get from testing.
The module provides a snapshot of the recommendations for running next-generation sequencing (NGS) in patients with solid tumours based on the strength of clinical data and supported by the ESMO Scale for Clinical Actionability of molecular Targets, a framework designed for ranking drug-genomic alteration matches by clinical actionability.
Furthermore, it highlights the recommendations to perform tumour NGS in clinical research centres and under specific circumstances discussed with patients. It also highlights recommendations to perform NGS to detect tumour-agnostic alterations in patients with advanced cancers where access to matched therapies is available.
The next part of the module elaborates on the key details from the Working Group recommendations on how genomics report should be structured and how the well structured genomics report informs the management.
The last part of the module elaborates on genomics profiling from the aspects of screening for clinical trials and how participation in clinical trials was transformative in terms of recent tumour-agnostic approvals.
Furthermore, in this module, the author explores a growing landscape of molecularly-guided treatment options in oncology, in terms of socio-economic and ethical implications, and emphasises that true collaboration, multi-stakeholder and trans-sectoral approaches are key to navigate through arising complexities in precision oncology.
Christoph Benedikt Westphalen has reported:
Financial Interests:
Invited Speaker, Personal: Amgen, Astra Zeneca, Bayer, BMS, Celgene, Chugai, Falk, GSK, Janssen, Lilly, Merck, MSD, QuIP GmbH, Roche, Servier, Sirtex, Taiho.
Other, Personal, Travel Support: Bayer, Celgene, Janssen, RedHill, Roche, Servier, Taiho.
Advisory Board, Personal: BMS, Celgene, Incyte, Rafael, RedHill, Roche, Shire/Baxalta.
Expert Testimony, Personal: Janssen.
Research Grant, Personal and Institutional: Roche.
Non-Financial Interests:
AIO – Arbeitsgemeinschaft Internistische Onkologie (Germany), Officer.
EU Commission – DG RTD, Advisory Role, Member of the EU Commission Mission Board for Cancer.
German Federal Ministry of Education and Research, Advisory Role, Member Forum Zukunftsstrategie.
