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“Options and hope.”
This is what the arrival of precision genomics in Bloomington is offering cancer patients, according to Laura Lourdes, MD, lead physician for precision genomics for the South Central Region. The program officially launched in January and five patients have already been reaping the benefits.
Precision medicine is a phrase that is often used to describe how genetic information about a person’s disease is being used for diagnosis and treatment. Advances in genomic technology allow the data from the patient’s DNA to be sequenced, and through this process, can reveal what makes cancer tick. Next-generation sequencing provides information that allows the cancer to be precisely targeted with the use of FDA-approved drugs or clinical trials.
The precision genomics program at IU Health offers a personalized patient experience unlike most any other, according to Will Hundley, executive director of precision genomics for IU Health. “We use whole genome DNA sequencing,” he said, “using the patient’s specific biological information to customize the course of treatment for those diagnosed with advanced forms of cancer.”
The IU Health program, introduced in April 2014, tests more than 21,000 genes per biopsy, including DNA, RNA (Ribonucleic acid) and Protein, compared to other programs that might test just over 300 genes and only include a DNA panel. This allows providers the ability to find a more specific treatment when needed.
“It’s rare to be able to offer world-class care such as this at such a local level, without having to travel to a big city,” he added. “But we have the infrastructure in place to be able to do this and do it well.”
Bloomington’s program provides genomic consultation and cancer diagnostic genomic testing. Patient education is also offered. “It’s a comprehensive approach with the patients involved as part of the solution,” Hundley said.
Patients are referred to the program by their medical oncologist.
“This program does not replace the patient’s cancer provider,” said Lourdes, who trained in IU Health’s Indianapolis precision genomics clinic before moving to Bloomington to launch the program for the south central region. “Instead, we work in tandem with them to bring you the best care close to home. This is the new era of personalized medicine.”
Systemwide, IU Health has worked with over 1,600 patients for sequencing since April 2014. More than 71 percent of those cases have resulted in a clear target to attack and fight the cancer. In addition, almost 70 percent have been referred to a clinical trial as part of their treatment plan. Sometimes the plan of attack can include the administering of FDA- or non-FDA-approved drugs as well.
A unique aspect of the program is that IU Health physicians and scientists examine both the tumor genetics as well as the genetics that the patient is born with (known as the germline DNA). With these two pieces of information, IU Health oncologists are then able to better predict the effectiveness, as well as any possible toxicity reactions of a particular drug, therefore minimizing harmful side effects when recommending a therapeutic option to a patient.
Bloomington’s precision genomics clinic focuses on “solid tumors that are advanced or late-stage and otherwise defined as incurable,” Lourdes explained, adding that the IU Health Tumor Board is the core of precision genomics operations throughout the state.
“This gives patients access to university-based experts who are renowned in genomics and cancer care, nationally and internationally,” she said. The tumor board reviews all sequencing data and discusses treatment plans and potential safety issues for each individual case.
Each patient also receives care from an interdisciplinary team, which includes Dr. Lourdes, a registered nurse, a pharmacist and a research nurse.
Dr. Lourdes says another goal of the program is to bring more clinical trials to the region. “These open and close often and new drugs come out every day,” she said. “We want to bring those options and treatments to people in the south central region.”
Dr. Lourdes sees patients in Bloomington and Bedford, but the precision genomics clinic is only located in Bloomington, at IU Health Southern Indiana Physicians Hematology and Oncology at 514 W. Second Street.
“We are in the toddler stage,” Lourdes said, “but the more we see, the more we can do to provide personalized medicine. Through cutting-edge genetic testing and access to these drugs, this program and our experts will be able to identify the right drug, for the right person, at the right time.”
Featured IU Health Southern Indiana Physicians provider seeing patients for precision genomics in the south central region:
Laura Lourdes, MD812.676.4444