Precision Genomics

Understanding Precision Genomics

At IU Health, precision genomic testing will look at the genetic structure of your tumor. This helps us discover “actionable” mutations that can be targeted with therapy. These discoveries can lead to new treatment recommendations that may effectively treat your cancer on a personalized level.

Who's Eligible?

• Adults with metastatic cancer with a solid tumor may be referred to our program. Our program requires a referral from the patient's treating doctor. We recommend that patients are referred into the program as early as possible even if other standards of care are being pursued.
• Riley Children’s Health offers a pediatric program.

Genomic vs. Traditional View of Cancer

Traditionally cancer has been defined based on which body part the cancer started in (i.e. breast, lung, etc.). Actually cancer is in its essence is a disease of the DNA. Cancer is caused when there are certain typos in the blueprint of that DNA.

A look at the genomic level reveals surprises. There are some forms of breast cancer that looks like ovarian cancer, more than breast cancer. Some patients with prostate cancer have a genetic mutation that is most commonly associated with breast cancer. There are many examples like these.

The shift is thinking about the cancer more in terms of what drives the cancer as opposed to what body part it started in.

Why IU Health for Precision Genomics

The IU Health Precision Genomics program is changing cancer care by partnering with you.

• Your doctor remains your doctor, and together you will decide which recommendations to pursue and when
• You can remain close to home with our convenient locations across central Indiana
• You and your doctor get access to the most leading-edge science in genomic testing
• You and your doctor get access to highly specialized experts where science meets the art of interpretation—this includes multidisciplinary clinical conference review, personalized recommendations and education
• You and your doctor can receive assistance with pursuing approval for genomic-directed therapy recommendations, if needed

Our Approach to Precision Genomics

A tissue sample of your DNA will go to a leading-edge laboratory, where your DNA will be sequenced to better understand your cancer’s DNA. The findings will be analyzed by more than 20 multi-disciplinary IU Health and Indiana University School of Medicine faculty and staff, including oncologists, genomics scientists, pathologists, pharmacy specialists, nurses and clinical trial specialists.

This comprehensive Precision Genomics Clinical Conference team will use the latest genomic tools to determine the best available treatment options for you, while minimizing the potential for adverse side effects. A better quality of life and more time with your loved ones is critically important to the Precision Genomics team.

There is no one-size-fits-all plan. The recommendations that the Clinical Conference team puts forth will come after much deliberation, looking at best standards of care, as well as new and innovative care that may be appropriate for you.

What to Expect

Once you are referred, you’ll meet with a precision genomics team at a nearby IU Health Precision Genomics location for an initial consultation and testing. After your genomic findings have been reviewed by our team, you may revisit us to review your options. You and your doctor will review the recommendations and decide what to pursue and when.

Precision Genomics at IU Health: Step by step

1. Talk about it. You and your doctor should talk about whether the Precision Genomics program may be right for you. If you qualify and decide to move forward, your doctor will submit your cancer profile to the IU Health Precision Genomics program.

2. Initial consultation and testing. Once you’ve been accepted to the program, you’ll meet with a precision genomics team at a nearby IU Health Precision Genomics location.

During this appointment, you will:

• Learn more about the program and have your questions answered
• Be examined by one of our medical oncologists
• Have blood drawn
• Have a biopsy

3. Genomic testing. Your tumor tissue’s DNA will undergo DNA sequencing, which includes a review of how your genes are arranged. Your own genetics, known as germline DNA (the DNA you were born with), may also be analyzed. This allows us to scan everything and have the most comprehensive view of your cancer’s attributes.

4. Your evaluation. The multi-disciplinary Clinical Conference experts will review the results of your genomic testing and will debate and discuss the best genomic-directed treatment options for you. They will also determine if your DNA is predisposed to respond positively or negatively to existing cancer treatment therapies, which will help rule in or rule out specific drugs. This team will then compose comprehensive treatment recommendations that may include starting new drug therapies or participating in clinical trials.

5. Reviewing your options. Once the Clinical Conference team outlines its recommendations, you will have another consultation appointment at the nearby Precision Genomics clinic to review them. Along with certain treatments, you may also be given the opportunity to participate in a clinical trial.

6. Path forward. You and your oncologist will review the team’s recommendation to decide together what course of action to take that may be most effective in treating your cancer and providing a better quality of life.

Genomic Testing

Genomic testing—sometimes known as DNA sequencing, whole or partial genome sequencing – is the process of discovering individual cancer genes with mutations. The IU Health Precision Genomics program is one of only a few in the United States to provide comprehensive genomic testing, which may include testing the whole genome DNA of 3 billion base pairs, 20,000 genes. Learn more about genomic testing.

Questions to Ask About Genomic Testing

This is a big step in your cancer care, and you probably have a lot of questions. Here are some questions to get you started:

• What is genomic testing and why is it a good option for my kind of cancer?
• How is this different than other options my doctor and I have explored?
• What does the biopsy involve?
• I’m currently undergoing treatment for my cancer. Does that mean I have to wait to be seen?
• When will I know what options are available to me?
• If I am in a clinical trial will I know what drug I am being given?

We strongly recommend that you bring along a partner or a good friend who can help you by listening and also taking notes.

Research

Precision genomics and cancer treatment is evolving at a rapid pace and research is the key component to the evolution. In addition to our clinical precision genomics program, IU Health and Indiana University researchers are bringing promising discoveries to you as quickly as possible through clinical trials.

As part of the part of our program, our team will also look for clinical trials for which you may be a match. This extensive search extends beyond clinical trials offered by IU Health and Indiana University.

Additionally when you visit our program, you will have the opportunity to share, with your permission, your genomic information to help guide our research team as they discover and develop future cancer treatments.