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New service brings power of genomics to patient care
Date:11/22/2011

ncing a patient's entire genome are decreasing, it's still not economically feasible to perform whole-genome sequencing for clinical treatment of patients. Sequencing of multiple genes known to influence a disease will produce the information physicians need to guide treatment decisions.

The services provided by GPS@WUSTL will be paid for by a mixture of revenue streams, including health-care insurers, hospitals, patients and federal research grants, and through partnerships with companies and foundations.

"Patients throughout the country can access GPS@WUSTL through their personal physician," says John Pfeifer, MD, PhD, vice chairman for clinical affairs in pathology and immunology. "After we receive a patient's tumor sample, results will be returned in days to weeks in a report identifying the mutations detected. We will also provide the names of specific drugs that target the mutations' effects as identified in peer-reviewed medical literature."

GPS@WUSTL administrators chose the 28 genes in the first test because all have implications for cancer therapy. The test can easily be adapted to add newly discovered mutations as they are clinically validated.

To describe how multiple genes can affect treatment, GPS@WUSTL Medical Director Shashi Kulkarni, PhD, cites acute myeloid leukemia (AML), a blood cancer.

"In AML, patients who have a mutation in a gene called FLT3 can be treated with a drug that suppresses the mutation's effects, improving chances for recovery," Kulkarni says. "Mutations in another gene, DNMT3A, suggest a poor prognosis and call for initial treatment with a bone marrow transplant, a riskier therapy normally reserved for patients whose AML recurs after chemotherapy."

As another example, some lung cancers harbor a mutation in a gene called EGFR. These tumors can be killed much more effectively by specific chemotherapy drugs, so knowledge of the EGFR status helps oncologists choose the best treatme
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Contact: Joni Westerhouse
westerhousej@wustl.edu
314-286-0120
Washington University School of Medicine
Source:Eurekalert

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