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An interview with Dr. David Roth – Penn Medicine – Tackling the challenges of leveraging genomic data across both research and clinical settings at Penn Medicine

On March 29, Dr. David Roth, Chair of Pathology and Laboratory Medicine and Director of the Penn Center for Precision Medicine at the University of Pennsylvania Perelman School of Medicine will co-present a webinar “Incorporating Genomic Data into Clinical Practice”. The webinar will detail the work he has performed within the school of medicine to help build the genomic testing and data collection functions that span both research and clinical operations. Dr. Roth recently took time to speak with the Journal of Precision Medicine to discuss the current status of his projects and the role of the Center for Precision Medicine at Precision Medicine.

What was the genesis for creating the Center for Precision Medicine at Precision Medicine and what were the unique elements that made this process viable in how to treat patients?

After I arrived in 2011 the vision was to make something as practical and useful as possible that would enable us to bring the advantages of sequencing for oncologists and patients alike. It became clear that small panels were the way to go. We started with one off the shelf panel from Illumina and were one of the early adopters of this type of approach. Our model was to embed ourselves in the fabric of the cancer center and the medical oncology space, and we partnered with these groups to design tools that were most useful to them. Having the oncologists playing an integral role in the design of the tests really worked well.

To date how many panels have you run, and do you run these panels on all of the patients that come through Penn Medicine?

We have been able to complete close to 5,000 panels since February 2013, and are on pace to exceed 2,500 in 2016. We have been very fortunate to gain a lot of experience in a short period of time! These numbers are expected to rise when our in house solid tumor panel 2.0 is released as this will cover breast, ovarian, and prostate cancers. We expect to be doing this testing on most Penn cancer patients in the relatively near future.

Out of the 5,000 panels you have run how many of those patients has the therapy been changed or adjusted based on the results.

That is the big question! Again in our recent analysis of the non-small cell lung cancer group a respectable fraction of the 1,000 patients (roughly 20%) have mutations that would specify an FDA approved targeted therapy as of February 2015. We are currently analyzing the data to determine how many of these patients actually received the targeted therapies. Our next step, and part of my new role as Director of the Center for Precision Medicine, is to work closely with the Abramson Cancer Center to design systems that ensure that each patient identified by these genomic tests receives the appropriate targeted treatment at the right time. To be able to achieve this we are building a robust system that makes sure we keep track of everyone, with appropriate decision support and carefully designed clinical care pathways. We are also building systems to track outcomes, so that we can continually improve our results. Developing such an integrated approach is not easy, but we think it is a necessary step to continue to deliver on the promise of precision medicine.

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