Professor Nazneen Rahman, head of genetics at the Institute
of Cancer Research (ICR)
and the Cancer Genetics Clinical Unit at the Royal Marsden, says:
'Genetic testing technologies have advanced dramatically in recent years. We
now have the opportunity to translate these improvements into better care for
cancer patients and their relatives'.
growing demand for cancer gene testing from patients and medical specialties,
and this is likely to continue.
Rahman is leading a programme which aims to develop a new model of genetic
testing to meet this increased demand. The Mainstreaming Cancer Genetics (MCG) programme is led by a team at the ICR in collaboration
with the Royal Marsden, the Wellcome Trust Centre for Human Genetics and Illumina.
for delivering greater cancer gene testing is to increase the number of
clinicians who are able to order tests, and to lower the barriers to them doing
tests have been carried out by geneticists via referral from oncology
departments. Another option is to develop a mixed model (oncology-genetics), where oncologists are
trained to carry out testing in people with cancer as a routine part of their
oncological care. This is the alternative being developed by the MCG programme.
Rahman said: 'We are working closely with colleagues in oncology to develop the
clinical infrastructure, educational tools and patient support systems required
to implement greater genetic testing for people with cancer'.
As a part of
the programme, the Royal Marsden is currently carrying out direct BRCA testing in eligible patients through the breast and gynaecology units. Oncologists are now able to bring the
test directly to the patient through their existing appointments. Patients are
referred to geneticists when pathogenic mutations are detected, or further
discussions are required.
Rahman explains: 'We aim to develop a model of cancer gene testing that is
capable of meeting the increased demand from patients and clinicians. We want
to develop an accurate, reliable, scalable system that may be implemented in other
NHS centres in the future'.
In time, the
programme aims to increase the number
of genes being tested and the
number of patients who are able to benefit.
A survey of
all 24 UK genetic centres found
that 75 percent would like to be
able to offer more cancer gene testing. Importantly, 92 percent reported increasing interest from non-genetic
clinicians in their region to have more cancer gene testing, and 96 percent predicted increasing
interest from patients and/or the public. Eighty-six percent were already undertaking research and pilot studies to
identify ways of increasing testing in genetics or through other specialties,
and 83 percent thought it would
be helpful to be able to test multiple cancer genes at once, for example in a
The ICR, in
collaboration with Illumina, has developed a new test, known as the TruSight Cancer panel, which can
analyse 97 cancer predisposition genes within a few weeks for a few hundred pounds. It will be ready for use in the
clinic in 2014.
Professor Nazneen Rahman was talking about her
work prior to her presentation 'The Impact of Genomics on Cancer Services' at the British
Society for Genetic Medicine's annual conference, held at
the Liverpool Arena and Convention Centre on Monday 16 September 2013.