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Published on September 30, 2016

Precision medicine tumor board offers cancer patients new treatment options

A new statewide forum is shedding light on precision medicine in cancer care.

Gundersen Health System medical oncologist Benjamin Parsons, DO, and Gundersen oncology researcher Paraic Kenny, PhD, are among a team of Wisconsin physicians, pathologists, geneticists, pharmacologists and basic science researchers who sit on the Precision Medicine Molecular Tumor Board (PMMTB).

The team meets twice monthly to analyze cancer patient cases throughout the state, interpreting genetic information about specific mutations and recommending therapy that may be more effective than the standard of care.

"With precision medicine, we're trying to understand mutations of cancer cells and then use a targeted therapy to direct the treatment for patients on an individual basis," explains Dr. Parsons.

The PMMTB, which formed in September 2015, is a partnership between the University of Wisconsin Carbone Cancer Center and regional medical centers such as Gundersen Health System.

"There are only about 35 precision medicine tumor boards across the country so we're part of a relatively elite group," states Dr. Parsons.

The tumor board studies specific genes that are driving an individual's cancer. Based on identified mutations, they look at clinical trials the patient may be eligible for that are targeted therapies rather than standard-of-care chemotherapies. Sometimes, the recommendation is to use an off-label treatment. Dr. Parsons provides this example: "In lung cancer, the EGFR gene mutations have a very specific drug that can be used to target it. But we know the EGFR gene can be mutated in other cancers. We're trying to use those drugs that are already approved for a different indication."

For a case to be reviewed by the PMMTB, a patient's tumor must be sequenced to identify its DNA mutations, and the patient must no longer be responding to standard therapy.

Gundersen Medical Foundation's Kabara Cancer Research Institute recently acquired its own DNA sequencing equipment. "Sequencing tumors in-house will reduce turnaround time, be more cost effective and dramatically expand the number of patients to whom we can offer precision medicine," explains Dr. Kenny.

The work of the PMMBT helps both clinicians and patients. "As a clinician, it's really difficult to stay on top of what these changes mean at the genomic level, and you learn a lot more about whether a mutation may be significant or not from the Board's review than from the sequencing report," Dr. Parsons says. "Even if I walk away having presented a case and there isn't a clinical trial or off-label treatment option available, it is still a huge benefit to my patients because I leave with a better idea of the biological behaviors of their cancer and potential future treatment options."

To refer a patient case for review by the PMMTB or to ask questions, contact Dr. Parsons via MedLink at (800) 336-5465. In La Crosse, call (608) 775-5465.

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