Background
Recent advances have provided the possibility of incorporating genetic sequencing into clinical oncology. For many patients with advanced cancer, either the standard of care is ineffective or no standard of care therapy exists. In such cases, patients often pursue clinical trials, although there is no standard means to assess which therapy will work over another. Genetic sequencing of tumors from such patients could inform choices regarding clinical trials or targeted therapy based on the molecular characteristics of the cancer. However, little is known about how patients and clinicians will respond to the use of genetic sequencing in clinical oncology. Therefore, experts from the University of Michigan in clinical oncology, clinical genetics, genomic science, bioinformatics, clinical pathology, social and behavioral sciences, and bioethics have joined together to address the potential for individual cancer care through the Michigan Oncology Sequencing Center (MI-ONCOSEQ) research study.
MI-ONCOSEQ consists of three integrated projects: Project 1 (Clinical Genomics) integrates somatic and germline sequencing into the clinical practice of oncology; Project 2 (Sequencing Informatics) processes biospecimens and performs integrative sequencing and analysis of tumors and Project 3 (Bioethics) examines the psychosocial and ethical issues expected to arise from identification and disclosure of genomic results to patients and clinicians.
Study Overview
The Bioethics component of the project evaluates the clinician and patient response to the informed consent process, delivery of genomic sequence results, and use of genomic results in the clinical management of patients with cancer. To develop ethically sound guidelines and policies toward cancer genomic sequencing disclosure, the study addresses questions such as: What do cancer patients and clinicians want to know (or not know) from such test results? How do we determine what information is worth sharing? How do we communicate sequence information in a manner that patients and clinicians will readily understand and respond to? How do patients react to this information?
Funding Source
The MI-ONCOSEQ study is funded by the National Institutes of Health (NIH) as part of the National Human Genome Research Institute’s (NHGRI) Clinical Sequencing Exploratory Research (CSER) program. Additional funding is provided by the Stand Up to Cancer-Prostate Cancer Foundation’s Prostate Dream Team Translational Cancer Research Grant and the University of Michigan Comprehensive Cancer Center.
Key Personnel
Scott Roberts, PhD, Principal Investigator
Arul Chinnaiyan, MD, PhD, Principal Investigator
Raymond De Vries, PhD, Co-Investigator
Brian Zikmund-Fisher, PhD, Co-Investigator
Wendy R. Uhlmann, MS, CGC, Co-Investigator
Elena Stoffel, MD, Co-Investigator
Michele Gornick, PhD, Postdoctoral Fellow
Lan Le, MPH, Project Manager
Natalie Bartnik, MPH, Research Associate
Selected Study Publications
Roberts JS, Gornick MC, Le LQ, Bartnik NJ, Zikmund-Fisher BJ, Chinnaiyan AM. (2019). Next‐generation sequencing in precision oncology: Patient understanding and expectations. Cancer Medicine. PDF.
Gornick MC, Ryan KA, Scherer AM, Roberts JS, De Vries RG, Uhlmann WR. (2018). Interpretations of the term “actionable” when discussing genetic test results: What you mean is not what I heard. Journal of Genetic Counseling.
Gornick MC, Cobain E, Lan LQ, Bartnik N, Stoffel E, Schuetze S, Talpaz M, Chinnaiyan A, Roberts JS. (2018). Oncologists’ use of genomic sequencing data to inform clinical management. JCO Precision Oncology. PDF.
Weipert CM, Ryan KA, Everett JN, Yashar BM, Chinnaiyan AM, Roberts JS, De Vries R, Zikmund-Fisher BJ, Raymond VM.(2018). Physician experiences and understanding of genomic sequencing in oncology. Journal of Genetic Counseling. 27(1), 187-196. PDF.
Robinson DR, Wu YM, … Roberts, JS, et al. (2017). Integrative clinical genomics of metastatic cancer. Nature. 548(7667), 297-303. PDF.
Ryan KA, De Vries RG, Uhlmann WR, Roberts JS, Gornick MC. (2017). Public’s Views toward Return of Secondary Results in Genomic Sequencing: It’s (Almost) All about the Choice. Journal of Genetic Counseling. PDF.
Gornick MC, Scherer AM, Sutton EJ, Ryan KA, Exe NL, Li M, Uhlmann WR, Kim SYH, Roberts JS, De Vries RG. (2017). Effect of Public Deliberation on Attitudes toward Return of Secondary Results in Genomic Sequencing. Journal of Genetic Counseling. 26(1), 122-132. PDF.
Mody RJ, Wu YM, … Roberts JS, et al. (2015). Integrative clinical sequencing in the management of refractory or relapsed cancer in youth. JAMA. 314(9), 913-925. PDF.
Roberts Research Group 