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Genomic Sequencing Improves Children’s Cancer Care

Child with cancer

(Vanessa Isabel, Wikimedia Commons)

2 September 2015. A study by medical researchers at University of Michigan shows sequencing of genomes and tumors of children with cancer provides their physicians with new information leading to changes in care given a large percentage of patients. The team led by Michigan pathology professor Arul Chinnaiyan published its findings yesterday in the Journal of the American Medical Association (paid subscription required).

Chinnaiyan and colleagues investigated a program at C.S. Mott Children’s Hospital in Ann Arbor, part of the University of Michigan health system, known as Peds-MiOncoSeq, a children’s version of an initiative to sequence the tumors and genomes of cancer patients to gain greater insights into mutations and other genetic causes of the patients’ cancer. Analyzing the sequence of nucleic acids in the DNA can reveal genetic variations among those sequences associated with disease conditions. This information can offer physicians more details about the cause of an individual’s condition, and lead to treatments needed to address it.

“This individualized genetic information helps us better predict what genetic change is driving a particular child’s tumor, what’s causing the resistance to the treatment, and how to predict response to certain treatments,” says pediatric oncologist Rajen Mody, the paper’s first author, in a university statement. “This knowledge can help us match each patient with the specific therapy most likely to benefit him or her.”

The study reported on results from 102 children and young adults, averaging 11 years old, enrolled in Peds-MiOncoSeq, who were among the program’s first participants. All of the participants had cancer of some form considered rare, relapsed, or unresponsive to treatment. Of the 102 participants, 89 percent had sufficient tumor tissue for analysis, with 7 in 10 participants (69%) having a solid tumor cancer, while the remaining 31 percent having a blood-related cancer.

Each of these individuals had their whole genome analyzed, as well as their tumors’ DNA and RNA — genetic instructions to cells transcribed from DNA. Families of the patients received counseling on the results the analysis, and the findings were reviewed by precision medicine panel, which made recommendations to the families and physicians.

Of the participants receiving genomic analysis, nearly half (46%) were offered findings of genetic anomalies that their physicians considered actionable, resulting in changes in diagnosis, identification of new drug targets, or genetic counseling for family members who may also be susceptible to inherited conditions. The results led to changes in treatments for 15 percent of patients, with 10 percent experiencing at least partial remission of their cancers for as long as 21 months. The authors note there was no control group to compare these result with standard cancer care.

The university spun-off a company, Paradigm Diagnostics, that performs genomic sequencing for cancer patients and clinical trials. Study leader Arul Chinnaiyan is a scientific advisor to the company.

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