July 23, 2018
Ribbon diagram of cancer mutations. (Image courtesy of National Library of Medicine)
VA's National Precision Oncology Program (NPOP), part of VA’s overall National Oncology Program, began in 2016. It aims to help provide targeted cancer care for Veterans, based on their genetic profiles, and facilitate their access to new investigational therapies through clinical trials. The program includes a research component through which patients can agree to have their clinical, genetic, and imaging data shared with researchers to help advance cancer care. All research samples are coded and contain no personally identifying information.
The program grew out of an earlier pilot conducted by VA's New England Healthcare System and the Massachusetts Veterans Epidemiology Research and Information Center. The pilot focused on Veterans newly diagnosed with non-small cell lung cancer, the most common type of lung cancer.
As participating Veterans are diagnosed, VA physicians take a specimen of their tumor and send it to qualified laboratories for targeted genomic sequencing, a process that determines the DNA sequence of genes known to play a role in cancer. The sequencing identifies specific mutations, or changes, that are causing the cancer to grow, allowing Veterans to benefit from drugs that are targeted to those mutations, and to take part in clinical trials of new drugs targeted toward their specific mutations.
As of August 2017, more than 1,000 tumor samples from 61 different facilities had been tested.
Principal investigator: Louis Fiore, M.D., MPH; VA Boston Healthcare System
Selected publications:
Fiore LD, Brophy MT, Turek S, Kudesia V, Ramnath N, Shannon C, Ferguson R, Pyarajan S, Fiore MA, Hornberger J, Lavori P. The VA point-of-care Precision Oncology Program: Balancing access with rapid learning in molecular cancer medicine. Biomark Cancer. 2016 Feb 29;8:9-16.
Fiore LD, Brophy MT, Ferguson RE, Shannon C, Turek SJ, Pierce-Murray K, Ajjarapu S, Huang GD, Lee C, Lavor PW. Data sharing, clinical trials, and biomarkers in precision oncology: Challenges, Opportunities, and programs at the Department of Veterans Affairs. Clin Pharmacol Ther. 2017 May;101(5):586-589.
