Open AccessIntegrating Somatic and Germline Next-Generation Sequencing Into Routine Clinical Oncology Practice
Author(s) -
J. Kevin Hicks,
Rachel Howard,
Phillip Reisman,
Jacob J. Adashek,
Karen K. Fields,
Jhanelle E. Gray,
Bryan McIver,
Kelly Johnston McKee,
Mandy Flannery O'Leary,
R. Serene Perkins,
Edmondo Robinson,
Ankita Tandon,
Jamie K. Teer,
Joseph Markowitz,
Dana E. Rollison
Publication year - 2021
Publication title -
jco precision oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.405
H-Index - 22
ISSN - 2473-4284
DOI - 10.1200/po.20.00513
Subject(s) - operationalization , workflow , context (archaeology) , health informatics , medicine , clinical decision support system , test (biology) , health care , genetic testing , decision support system , computer science , nursing , data mining , public health , paleontology , philosophy , epistemology , database , economics , biology , economic growth
Next-generation sequencing (NGS) is rapidly expanding into routine oncology practice. Genetic variations in both the cancer and inherited genomes are informative for hereditary cancer risk, prognosis, and treatment strategies. Herein, we focus on the clinical perspective of integrating NGS results into patient care to assist with therapeutic decision making. Five key considerations are addressed for operationalization of NGS testing and application of results to patient care as follows: (1) NGS test ordering and workflow design; (2) result reporting, curation, and storage; (3) clinical consultation services that provide test interpretations and identify opportunities for molecularly guided therapy; (4) presentation of genetic information within the electronic health record; and (5) education of providers and patients. Several of these key considerations center on informatics tools that support NGS test ordering and referencing back to the results for therapeutic purposes. Clinical decision support tools embedded within the electronic health record can assist with NGS test utilization and identifying opportunities for targeted therapy including clinical trial eligibility. Challenges for project and change management in operationalizing NGS-supported, evidence-based patient care in the context of current information technology systems with appropriate clinical data standards are discussed, and solutions for overcoming barriers are provided.