cancer genetics

Carlo Bifulco joins us today. He’s an Italian who helped persuade one of America’s largest not-for-profit health systems that providing more genomic information to cancer patients early on was the right thing. With 52 hospitals, over 1,000 physician clinics, more than 120,000 caregivers serving communities across seven states—Alaska, California, Montana, New Mexico, Oregon, Texas, and Washington—Providence and Carlo have quite a task ahead. We ask Carlo what is the state of comprehensive genomic profiling at Providence today?

It’s a hot question in the field today. Recently several studies arguing for increased testing for all breast cancer patients have been published in leading oncology journals.

Peter Beitsch is a breast cancer surgeon in Dallas Texas and co-author of one such study in the Journal of Clinical Oncology. He says that NCCN guidelines were created when tests were much more expensive and in an outdated context and that many patients are going under-diagnosed today.

Amy Taylor co-authored a letter to the editor hitting back against Peter’s paper, arguing that the tests he is promoting are not the right ones. She’s a genetic counselor at Cambridge University Hospitals.

Andrea Forman is also a genetic counselor. She is concerned about the long term care of the patients and questions whether we have the infrastructure to implement such increased testing now.

Join us for a lively back and forth on the state of breast cancer testing today.

The great promise of liquid biopsy technology is in early cancer detection. That is, it's the great future promise. Right? This past month at the annual cancer conference, ASCO, we heard about one such flagship company announcing just which technology they were going to use to do it--DNA methylation.

Well . . .it turns out there is a company, Laboratory for Advanced Medicine, that has been using DNA methylation for their liquid biopsy early cancer detection tests for a couple years already. Tests which are for sale now. On their website, they say they are "saving lives by detetecting cancer early." Presenting data for their technology back in 2017, the company offers two liquid biopsy tests commercially: one for liver cancer and the other, a broader test which confirms that a patient has a cancer, either lung, breast, colon or liver.

“This general test has clinical utility because often times the physician and the patient might have a concern about cancer because of symptoms. The physician has done other tests and eliminated other ailments, and the patient and physician have come to a working hypothesis that maybe the patient has a particular type of cancer. And so they do this test with us, and we report back with high accuracy that, yes, they do have a cancer or, no, they do not.”

Richard Brand, the CFO for Laboratory for Advanced Medicine, reviews with Theral the company’s tests, telling of several use cases over the past couple years and previews the tests on the horizon. The company looks to be ahead of the pack in a growing field.