By: John Fox, M.D.
Think about it – in today’s world doctors are lucky to know as much as they do about cancer, but cancers are usually treated by where they are found in the body. With comprehensive genomic profiling, doctors can better understand the gene alterations causing certain types of cancers, potentially allowing them to suggest a more targeted treatment.
Genomic profiling offers personalized cancer care
A genomic change is a difference in the DNA chain that makes up a gene and can affect the way a cell works. Some alterations cause cells to grow abnormally and may cause cancer. Imagine how doctors could treat patients if they better understood the individual parts of a patient’s DNA. What is causing cancer growth? How are cancer cells surviving? With genomic profiling, this can happen. Genomic profiling shows the reason for a patient’s specific cancer and guides decisions about more personalized treatment options, that otherwise might not have been considered.
Treating patients based on their genomic profile
Recent studies in genomic profiling show that treating cancer based on an individual’s tumor can be more effective.
Recent studies in genomic profiling show that treating cancer based on an individual’s tumor can be more effective.
Tumors with some genomic changes respond differently to different treatments. New drugs called ‘targeted therapies’ are more successful in treating cancer by targeting genomic changes that add to tumor growth. With this targeted cancer treatment, nearby healthy tissue stays safe and patients may experience fewer side effects than with some chemotherapies
The data that Foundation Medicine has on file for their comprehensive genomic profile test, FoundationOne, shows that 85 percent of patient cases have at least one genomic alteration that may enable doctors to:
- Recommend a targeted therapy to treat a specific cancer type
- Find a therapy to a similar cancer that could also be helpful
- Find an open trial for an experimental treatment
By knowing the exact genomic makeup of a cancer, genomic profiling can be used to customize a patient’s treatment recommendations.
Covering your cancer care options
Since the commercial launch of Foundation One in 2012, Foundation Medicine has conducted comprehensive genomic profiling tests for more than 21,000 patients. Unfortunately, these services have been billed as out-of-network services, requiring patients to pay higher out-of-pocket fees for the potentially life-saving test. Priority Health is now the first health plan in the country to cover genomic profiling through Foundation Medicine for its commercial members diagnosed with aggressive or difficult to treat forms of cancer.
Patients should be actively involved in their health care journey and treatment decisions. Offering genomic testing coverage will give patients more personalized information about their specific cancer at an affordable price and helps doctors to make the best treatment recommendations.
Priority Health provides comprehensive coverage and offers a complete package for members with cancer. From advanced care planning and oncology medical homes to advanced directives and now genomic profiling, its members with cancer have access to affordable and excellent health care, information about their disease and targeted treatment options.
Genomic profiling is just one more way Priority Health is transparent with its members and providers. Imagine if everyone had access to information to guide their health? According to the National Cancer Institute, about 1.6 million cases of cancer were diagnosed in 2013. If you or a loved one has cancer, ensure they have as much information as possible. Encourage them to ask about a genomic profile.
About the Author: John Fox, M.D., is senior medical director and associate vice president, medical affairs at Priority Health. He is responsible for medical technology assessment (medical and pharmaceutical), utilization and case management, physician profiling and pay-for-performance programs. He is also responsible for development of new programs, including shared decision making, advanced care planning, integrated specialty pharmacy program and value-based benefit designs.
