![]() ![]() Sometimes the pathologist must go back to a slide, or back to the tissue (which by then may be damaged or used up), or back to the patient to take more samples. To minimize costs with molecular testing, labs will often perform one single-gene or small panel test at a time, wait for the first negative result, then go for a second round, and if that is negative, go for a third round. Where they are gaining ground is in turnaround time, or TAT. ![]() The challenge-and he believes it is their greatest-has been keeping up with increasing volumes and all the informatics and data that come with it. “So it was a little bit of an unusual pathway.” “It was a relatively easy process because of what we had available as a backbone,” says Bifulco. Validating the test in-house-in other words, proving its accuracy and reproducibility in delivering results-was not difficult, either, as they already had whole exome and small panel data sets to enable the validation. They’re not really what the oncologist wants to see for patient care.” “If you think of what CGP is competing with, either very small panels of genes or a sequential kind of testing where you do one gene test at a time, both of those options are obsolete, quite frankly when you can test against hundreds of genes and biomarkers at once. “It is really driven by clinical need,” says Bifulco. Fortunately, Bifulco had no trouble selling the cancer profiling program to Providence’s powers-that-be. TSO 500 evaluates both DNA and RNA from tumor samples to identify key somatic variants-or changes in the genetic code-critical for cancer development and progression, such as small DNA variants, fusions, and splice variants.ĭespite the advent of such technology, we’re still living in a time when most tumors are not sequenced. TSO 500 is a Research Use Only comprehensive pan-cancer assay designed to analyze 523 genes and genomic signatures, covering tumor biomarkers linked to guidelines and clinical trials. In order to enable GenOmic CGP testing, Providence implemented Illumina’s TruSight™ Oncology 500 (TSO 500) assay in-house two years ago. Providence’s CGP service, called the GenOmic cancer profiling program, can point patients toward targeted or immunotherapies that might not have been identified through single gene tests or panels. They run two Illumina NovaSeq™ 6000 instruments “continuously.” They perform Comprehensive Genomic Profiling (CGP), which uses next-generation sequencing to assess hundreds of cancer biomarkers from numerous tumor types in a single test. The Providence Molecular Genomics Lab offers genomics to all of them. Founded in 1859, Providence comprises 51 hospitals and 1,085 clinics in seven western states from Alaska to Texas. Now with a rapidly growing team of pathologists and bioinformaticians on staff, the lab is emerging as one of America’s largest clinical genomics operations. He joined the Portland-based team in 2008 by way of Milan, Yale, and Memorial Sloan-Kettering, drawn by the fact that Providence was at the forefront of immuno-oncology (IO), a field of medicine that uses the body’s immune system to fight cancer. In the future, what if you could sequence your cancer patients by the thousands, provide answers quicker, and deliver more effective treatment and better care-on a routine basis? For Providence, the nation’s third largest not-for-profit health system, that future is the present.Īt Providence Molecular Genomics Laboratory, which serves the entire Providence health system, Carlo Bifulco is the medical director who also oversees Providence Genomics.
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