Episode 226: Patient Education for Next-Generation Sequencing to Guide Cancer Therapy

“Nurses can bridge the information gap and help patients better understand that the information received from next-generation sequencing (NGS) can really help to determine which treatment they will respond best to, if there are therapies that won’t be effective, or if there are clinical trials that are open to them based on the results,” Danielle Fournier, RN, MSN, APRN, AGPCNP-BC, AOCNP®, CORLN, advanced practice RN in the department of thoracic surgery at MD Anderson Cancer Center in Houston, TX, told Stephanie Jardine, BSN, RN, oncology clinical specialist at ONS. Fournier discussed the advancements being made in NGS technology and how it can be used to care for patients with cancer. This episode was produced by ONS and sponsored by Foundation Medicine. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes NCPD contact hours are not available for this episode. ONS Next-Generation Sequencing Toolkit, Sample Report, and Discussion Tool ONS Biomarker Database Oncology Nursing Podcast episodes: Episode 169: How Biomarker Testing Drives the Use of Targeted Therapies Episode 172: Address Knowledge Gaps in Evidence-Based Precision Medicine Care Episode 180: Learn How Nurse Practitioners Use Biomarker Testing in Cancer Care ONS Voice articles: Oncology Nurses’ Role in Translating Biomarker Testing Results Advocate for Equal Access for Next Generation Sequencing and Clinical Trials Help Patients Understand Genomic Variants of Unknown Significance How DNA Sequencing Technologies Are Used in Cancer Care, Now and in the Future ONS clinical practice resources: Biomarker Testing Quick Guide Biomarker Testing for Genomics Variants: What to Know From the Laboratory Performing the Test Paired Somatic and Germline Testing Resource The Oncology Nurse’s Role in Somatic Biomarker Testing Biomarker Testing Nursing Process Understanding Genetic Variants Discussion Tool ONS Genomics Taxonomy ONS Genomics and Precision Oncology Learning Library International Society of Nurses in Genetics Position statement on informed consent National Comprehensive Cancer Network Guidelines National Comprehensive Cancer Network Biomarkers Compendium Information on Sanger sequencing Information on the Genetic Information Nondiscrimination Act Video series: Seq It Out To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email [email protected]. Highlights From Today’s Episode “With next-generation sequencing (NGS), multiple biomarkers can be evaluated using one test. So, in cancer care, we’re learning that any given tumor may harbor a variety of variants. So, if we’re considering using in situ hybridization (ISH) or fluorescence in situ hybridization (FISH) to identify biomarkers, multiple assays may be needed and may need to be performed in order to test for multiple variants.” Timestamp (TS) 10:21 “There are multiple testing strategies that can be used with NGS technology, which is kind of what makes it so versatile. What type of testing is most appropriate really depends on the patient’s risk factors, their diagnosis, their cancer stage, what testing has previously been completed, and what tissue is available for analysis.” TS 12:00 “Within oncology care, there is a role for NGS in the identification and management of both solid tumors and hematologic cancers, and this role is likely just going to continue to expand. So, really there’s been an increased focus on genomic pharmacotherapy and targeted therapy, and this is playing an ever-greater role in the treatment of cancer. So, NGS will really continue to serve as a means to take a closer look at a patient’s cancer at the molecular level and hopefully match patients with treatments that will be most effective at treating their cancer.” TS 20:54 “In reality, there’s an expanding role for NGS testing in the diagnosis of many complex diseases. So, I think more than likely what we’re going to see is that the indications and utility of NGS is only going to continue to grow in both the oncology setting as well as the non-oncology setting.” TS 23:08 “The oncology nurse really plays a key role in several important steps along the way. The first place they may be involved is in the informed consent process. Many—but not all—hospitals require patients to sign consent for genetic and genomic testing and this is just acknowledging that the patient is making an informed and autonomous decision related to their health care. Nurses may also play a role in the collection of a tissue sample or blood sample. And once testing has been completed, nurses may play a role in discussing the NGS results with patients.” TS 24:03 “Nurses really can help to somewhat bridge this information gap and help patients better understand that the information received from NGS can really help to determine which treatment they will respond best to, if there are therapies that won’t be effective, or if there are clinical trials that are open to them based on the results. And these are all really important considerations for cancer treatment.” TS 36:21