Gene Panels: The Next Step in Hereditary Cancer Evaluation

Numerous genetic mutations are associated with certain types of hereditary cancer. Genetic testing using next-generation sequencing technology allows for the analysis of multiple genes at one time (panel testing), and these panels are commercially available. Using a multigene panel, physicians are able to identify important mutations beyond single-gene mutations. To be beneficial, multigene panel testing must provide clinically relevant and actionable data that will result in changes in patients' treatment and surveillance regimens.


This resource is more relevant to the oncology specialist.


Type Multimedia
CME Available No
Topic
Cost Free
Note



Genomic Competencies

Experts from the disciplines listed below have tagged this resource as fulfulling genomic competencies.

Pharmacist

  • Basic Genetic Concepts
    • B3:   To identify drug and disease associated genetic variations that facilitate development of prevention, diagnostic and treatment strategies and appreciate there are differences in testing methodologies and are aware of the need to explore these differences these differences in drug literature evaluation
    • B4:   To use family history (minimum of three generations) in assessing predisposition to disease and selection of drug treatment
  • Genetics and Disease
    • G2:   To assess the difference between clinical diagnosis of disease and identification of genetic predisposition to disease (genetic variation is not strictly correlated with disease manifestation)

Physician Assistant

  • Patient Care
    • 1:   Gather family history information and construct a multigenerational pedigree.
    • 2:   Identify patients who would benefit from referral to genetics professionals
    • 3:   Distinguish between genetic screening and genetic testing
    • 4:   Incorporate genetic tests into patient management

Physician

  • Family History
    • P-FH1A:   Patient Care
      • 1A1:   Conduct patient interview to assemble family history
      • 1A2:   Use standard pedigree symbols in assembling family history
      • 1A3:   Recognize patterns of Mendelian inheritance and calculate simple Mendelian risks; provide this information to patients and family members as appropriate
      • 1A4:   Use empirical risk figures to provide appropriate information for complex (multifactorial) medical conditions.
      • 1A5:   Recognize that traits may cluster in families due to multifactorial rather than Mendelian patterns of inheritance
      • 1A6:   Formulate an action plan to address relevant family history information
  • Genomic Testing
    • P-GT2A:   Patient Care
      • 2A1:   Discuss the indications for genomic testing - specifically the benefits, risks, and alternatives
      • 2A2:   Explain the implications of placing genomic test results in the patient’s medical record
      • 2A3:   Discuss the possibility of incidental findings and how they will be handled
      • 2A4:   Discuss risks of having genomic testing done: e.g., psychological implications for the individual as well as the family; the potential for discrimination; and the potential effect on insurance coverage.
      • 2A5:   Explain to the patient issues of costs and financial coverage of genomic testing
      • 2A6:   Order, interpret, and communicate the results of appropriate genomic tests, within the physician’s scope of practice
      • 2A7:   Provide referral to an appropriate specialist for genomic testing of a condition outside the physician’s scope of practice
      • 2A8:   Respond to the results of an abnormal genetic screening test, such as newborn screening, including immediate management and appropriate referral
    • P-GT2B:   Knowledge for Practice
      • 2B1:   Describe the major forms of genomic variability
      • 2B2:   Explain how different genomic changes may result in different phenotypes
      • 2B3:   Recognize that genomic tests require interpretation with respect to the patient’s clinical status (e.g., pathogenic, likely pathogenic, benign)
      • 2B4:   Explain the concepts of analytic validity, clinical validity, clinical utility as they relate to genomic testing
      • 2B5:   Recognize that medically ’non-actionable’ genomic results can be useful to the patient and family (i.e., personal utility)
  • Patient Treatment Based on Genomic Results
    • P-PM3A:   Patient Care
      • 3A1:   Identify medical conditions and drug responses that have a strong genetic component
      • 3A2:   Recognize that variants affecting drug responses found in a patient may also have implications for other family members
      • 3A3:   Discern the potential clinical impact of genetic variation on risk stratification and individualized treatment