Genomics in Clinical Practice, Part 1: The Rise of Multiplex Gene Testing for Cancer

Medscape

 July 20, 2016

 

Editor's Note:
 
This is the first in a three-part series on Medscape Oncology designed to update and familiarize practicing oncologists with the most important issues in multiplex and genomic testing.
 
In the 20 years since the first cancer gene test became available, the number and variety of tools available to clinicians for genetic analysis has exploded, far outpacing researchers' understanding of their clinical use. At the recent annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago, experts discussed the rise of multiplex gene panels and what new studies show about their integration in cancer care.

Single-Gene Assays Give Way to Multiplex Testing

Types of Panels 

Table 1. Examples of Genes Included on Multiplex Gene Panels^(a)

Multiplex Panels in Practice

Single-Gene vs Multiplex Testing

Table 2. Posttesting Surgical Procedures for Patients With a VUS

I think it is really important to think about an individual's preference and their tolerance for ambiguity," said Dr Isaacs. "In June 2016, there is still a reasonable chance if you send someone for multigene panel testing that you will find a mutation in a moderate penetrance gene or you will get a VUS, and you have to make sure the patient feels comfortable with that. I think the technology has outpaced our medical knowledge, but our medical knowledge will catch up."

Dr Kurian disclosed research funding from Ambry Genetics, GenDx, Genomic Health, Invitae, and Myriad Genetics. Dr Idos disclosed research funding from Myriad. Dr Isaacs disclosed honoraria from Genentech/Roche, Pfizer, Genentech, and Novartis. Dr Weitzel has disclosed no relevant financial relationships.