Genetic sequencing: UW-OncoPlex at SCCA
A new diagnostic tool called UW-OncoPlex is making a positive difference in the treatments and outcomes of many Seattle Cancer Care Alliance (SCCA) patients. Developed by researchers at UW Medicine, UW-OncoPlex tests a patient’s tumor tissue for the presence of characteristic genetic abnormalities called driver mutations. Each driver mutation causes tumors to behave differently on the molecular level and, thus, have different vulnerabilities.
The UW-OncoPlex panel tests for most of the driver mutations we’ve identified as having a highly effective treatment currently available for use. If your tumor tests positive for a particular mutation, your doctor will know which treatment will likely be most effective for you.
Getting the right treatment as soon as possible greatly increases the odds of beating cancer. It’s easier to get rid of tumors before they’ve grown, multiplied, or spread to other parts of the body.
It’s also a lot easier on you, the patient. The precision of UW-OncoPlex means that doctors can avoid prescribing treatments that are known not to work on cancers caused by specific mutations. This means saving patients from adverse side effects, as well as cycles of hope followed by disappointment.
Diseases targeted and treated
Currently, frequent requests for an UW-OncoPlex assay come from doctors specializing in the diseases listed below.
Melanoma. UW-OncoPlex identifies three primary genes that cause variants of melanoma.
Lung Cancer. Non-small cell lung cancer has four characteristic mutations in the UW-OncoPlex panel. In some cases, the associated drugs have extended patients’ lives by 14 months—a significant improvement for patients with this disease.
Leukemia. Acute myelogenous leukemia (AML) patients are benefitting from comprehensive molecular testing from the UW-OncoPlex panel for disease prognostication to guide individualized treatment.
Sarcoma. Because there are actually more than 60 distinct types of sarcoma, doctors expect significant benefits as the UW-OncoPlex panel grows. Gastrointestinal stromal tumor has seen the most success to date. There is a strong correlation between this cancer, known as GIST, and mutations in two genes in the UW-OncoPlex panel.
How UW-OncoPlex works
Rapid advancements in the power of genetic sequencers, combined with new insights into the workings of cancer on the molecular level, are the key ingredients in SCCA’s diagnostic tool, UW-OncoPlex.
Patient benefits
UW-OncoPlex represents a significant milestone in the development of Precision Medicine. Until recently, all patients with a particular type of cancer—for example, lymphoma or breast cancer—would most likely be treated with a similar regimen. The initial treatment would be the one with the best odds of success for the patient population as a whole. If the first treatment didn’t work, oncologists would move on to the next best option, again based on the percentages.
The future of precision medicine
Dr. Colin Pritchard, one of the key developers of UW-OncoPlex, believes that the test’s diagnostic capability is the beginning of a “paradigm shift in cancer treatment.” He immediately adds the caveat: “We are still in early days of this model.”
The ongoing challenge will be adding more genes to the panel. Technically this is not difficult. The platform is easily scalable.
UW-OncoPlex facts
UW-OncoPlex is a multi-marker cancer-sequencing test developed by Colin Pritchard, MD, PhD, and his colleagues at UW Medicine’s Department of Laboratory Medicine. The team has many years of experience using genetic sequencing to assay individual genes.
The availability of high-powered Next Generation Sequencing technology, capable of sequencing entire genomes, has enabled the UW-OncoPlex team to build a panel that analyzes hundreds of genes simultaneously for mutations.
What to expect
Doctors order UW-OncoPlex just as they would any other lab test. Because UW-OncoPlex sequences a tumor’s DNA—not that of the patient’s normal cells—a tissue sample is required. The only exception is for leukemia patients; in this case, DNA is taken from blood or bone marrow samples.
Many patients will already have had surgery and/or biopsies taken prior to the UW-OncoPlex assay. In that case, nothing further may be required. It’s standard practice for labs to preserve your tissue samples; if enough is still available, we can use it to extract your tumor’s DNA. However, if there’s no tissue on file, then you and your doctor will need to discuss the risks and benefits of having a biopsy performed specifically for UW-OncoPlex.
Currently, the turnaround time for your doctor to receive the UW-OncoPlex results is approximately two months.