VA Precision Oncology Program (POP)
VA oncologist Dr. Bruce Montgomery meets with Navy Veteran Allen Petchnick at the VA Puget Sound Health Care System in Seattle. (Photo by Christopher Pacheco)
The VA Office of Research and Development (ORD) conducts state-of-the-art precision oncology (cancer) research to improve care for Veterans and others with cancer. Precision oncology is an approach that looks at an individual's genes to select the best cancer treatment and care for that person. Genetic samples can be collected in several different ways, for instance, from a blood sample or cancer tumor biopsy.
VA recognizes the importance of using genetic and clinical data to find better treatments for Veterans with cancer and to guide care decisions. Efforts like partnering with the National Cancer Institute (NCI) help ensure that Veterans have access to cutting-edge cancer care. The NCI and VA Interagency Group to Accelerate Trials Enrollment (NAVIGATE) is an initiative that helps Veterans gain access to NCI-funded cancer clinical trials—giving them easier access to new therapies like precision medicine, immunotherapy, and new cancer drugs.
The Applied Proteogenomics Organizational Learning and Outcomes network, or APOLLO, is a partnership between VA, DOD, and the NCI. The network aims to translate real-world data into better clinical care for Veterans and active-duty service members with cancer. Data-sharing resources developed by the NCI and its partners play a key role. VA Research is expanding the number of sites that will contribute tissue samples to the APOLLO network.
Within VA, an increasing number of Veterans with advanced cancer have access to genetic sequencing that is used to identify "actionable" mutations in cancer tumors that can guide clinical care. That genetic data also provides opportunities (with Veteran consent) to design precision oncology clinical trials that examine the effectiveness of new and repurposed FDA-approved drugs.
Precision Oncology Programs and Partnerships
VA Research has established a number of precision oncology programs targeted to specific types of cancer:
Lung Cancer―The Lung Precision Oncology Program (LPOP) network helps clinicians diagnose lung cancer at earlier stages (when survival rates are higher) and increases opportunities for Veterans to participate in clinical trials. The network uses a hub-and-spoke model to reach Veterans in rural and less-urban areas of the country.
Prostate Cancer―Prostate cancer is the most common cancer diagnosis in U.S. Veterans, affecting approximately 15,000 Veterans each year. In 2016, VA Research partnered with the Prostate Cancer Foundation to establish the Precision Oncology Program for Cancer of the Prostate (POPCaP). This program seeks to use precision medicine to tailor individualized treatments for Veterans with prostate cancer.
Breast Cancer―VA Research is building new infrastructure to advance breast cancer research. In late 2020, VA launched a new strategic partnership with Duke University and Baylor College of Medicine to help build VA’s National Women Veterans Oncology System of Excellence. The partnership will seek to recruit top oncologists specializing in breast cancer, develop national tumor boards, and increase Veteran access to cancer clinical trials.
Rare Cancers―VA Research is building partnerships with agencies like the NCI and the National Institute of Dental and Craniofacial Research to address rare cancers in Veterans. As a group, rare cancers affect fewer than 40,000 people a year and account for 27% of all cancers in the U.S., according to the NCI. To help address cancers that occur less often in the Veteran population, VA will also use virtual clinical trials.