A recent study has shown that personalized treatments based on a patient’s genome can greatly benefit the patient. In 2016, The Jackson Laboratory (JAX), a National Cancer Institute-designated Cancer Center, initiated the Maine Cancer Genomics Initiative (MCGI) to bring advancements in cancer care to rural Maine patients. Following the successful expansion of genome tumor testing and targeted cancer treatments throughout Maine, the MCGI team has provided compelling evidence that genome-matched treatments can significantly benefit patients.
is a report from MCGI that has been published in npj Precision Oncology. The report shows that only 17% of patients who were tested received treatment that matched their genome. This indicates a large gap between the testing and the delivery of treatment based on genomic information. However, those who did receive treatment that matched their genome were 31% less likely to die within one year compared to those who did not receive matched treatment. While this study is observational, the results clearly show the potential for a significant one-year survival benefit from genomic tumor testing and matched treatments.There were several reasons why cancer patients did not get treatments matched to their genome after their tumor’s DNA was sequenced. Some patients did not have a detectable actionable tumor variant, so they received standard care.
According to Jens Rueter, M.D., chief medical officer of JAX and medical director of MCGI, for other patients, it was a matter of care delivery. Some patients may have had an actionable tumor variant, but they could only access the treatment through a clinical trial that was not available in rural Maine. Alternatively, their community hospital may not have been able to provide a treatment that was already on the market.The MCGI was established in 2016 due to the limited availability of advanced genomic testing and targeted therapy options for cancer patients in Maine. Many patients were unable to travel to Boston or New York for treatment, so the MCGI was created to provide access to the latest precision oncology technology and treatment. By 2020, the MCGI had partnered with all 13 oncology practices in Maine.The Medical College of Georgia Institute for Precision Medicine (MCGI) has provided genomic education to oncologists and healthcare professionals, as well as free access to genomic tumor testing for their patients. They also offer detailed consultation about test results with precision oncology experts through a genomic tumor board. Follow-up with MCGI patients revealed that 399 out of 1,052 who did not receive genome-matched treatments died within 365 days of consent, compared to 63 out of 206 in the genome-matched group. After adjusting for baseline characteristics, the analysis showed thThe genome-matched group had a 31% lower risk of dying within the first year compared to those who received standard care, despite only 9% being able to participate in a clinical trial. This lower participation rate may be due to the rural nature of Maine. In the MCGI study, 17% of tested patients received genome-matched treatments, which is consistent with findings from a larger 2019 Veteran Affairs study. This suggests that the delivery of cancer care is not limited to Maine. Moving forward, the MCGI program aims to improve the delivery of precision oncology care.
Whether it’s by utilizing its Genomic Tumor Board program to increase access to biomarker-driven clinical trials in Maine or implementing mobile outreach to bring treatments directly to patients who may otherwise be unable to access them.
However, the study has several limitations. Patients were mainly white and non-Hispanic, which reflects the population characteristics of Maine. The genomic tumor testing was offered for free, potentially increasing its use, and the study population included patients with various cancer sites and stages.
“Nevertheless, we have been running this program for seven years and have seen some very positive impacts.Rueter stated that genomic tumor testing and thorough biomarker analysis are crucial for patient outcomes, and they hope to implement these practices at a population level. The goal is to expand access to clinical trials and improve care delivery, with the Maine Cancer Genomics Initiative (MCGI) serving as a model for other states, particularly those with rural areas.
