The goal of this Exploratory Clinical Sequencing project is to integrate CLIA-certified germ line and tumor exome sequencing information generated by the Whole Genome Laboratory into the care of childhood cancer patients with high-risk solid tumors and brain tumors at the Texas Children's Cancer Center. Given the clinical nature of the project the dual principal investigators will be Drs. Donald W. Parsons and Sharon E. Plon, board-certified pediatric oncologist and medical geneticist, respectively. We will assess the impact of whole exome sequence data reported by a novel web-based platform with links to existing data for each variant reported and presented through a graphical display that will facilitate physician disclosure of complex data to parents. We will evaluate physician-parent communication and clinical decision-making in the context of two clinical questions (1) How does the availability of tumor whole exome sequence data affect physician recommendations regarding enrollment on specific clinical trials and the treatment plans chosen in the scenario of tumor recurrence? (2) How does the availability of germline whole exome sequence data affect cancer surveillance for patients and genetic testing and cancer surveillance for family members? Quantitative analysis of physician communication in disclosure of genome-scale data will be performed. Parental understanding and preferences for receiving genome scale data will be assessed. Ethical issues related to the appropriate use and reporting of whole exome data including possible incidental findings in a pediatric setting will be addressed. Baylor College of Medicine is ideally suited to conduct this study with the longstanding clinical oncology and cancer genetics practices, extensive expertise in genomics through the Human Genome Sequencing Center, the largest academic CLIA-certified molecular diagnostic laboratory in the United States and a track record of scholarship in ethical and social implications of genomics in the Center for Medical Ethics and Health Policy and physician-patient/parent communication in the Division of Health Outcome Services.

Public Health Relevance

The recent deluge of genetic data has translated into an exponential increase in the number of molecularly targeted pediatric cancer clinical trials. Therefore, an investigation of the impact of genomic sequence data on decision making of physicians and parents in relation to cancer risk and selection of treatment at the time of tumor recurrence would have significant impact and relevance for the field of pediatric oncology.

Agency
National Institute of Health (NIH)
Institute
National Human Genome Research Institute (NHGRI)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01HG006485-02
Application #
8393214
Study Section
Special Emphasis Panel (ZHG1-HGR-N (O1))
Program Officer
Hindorff, Lucia
Project Start
2011-12-05
Project End
2015-11-30
Budget Start
2012-12-01
Budget End
2013-11-30
Support Year
2
Fiscal Year
2013
Total Cost
$1,673,317
Indirect Cost
$576,031
Name
Baylor College of Medicine
Department
Genetics
Type
Schools of Medicine
DUNS #
051113330
City
Houston
State
TX
Country
United States
Zip Code
77030
Scollon, Sarah; Majumder, Mary A; Bergstrom, Katie et al. (2018) Exome sequencing disclosures in pediatric cancer care: Patterns of communication among oncologists, genetic counselors, and parents. Patient Educ Couns :
Porter, Kathryn M; Kauffman, Tia L; Koenig, Barbara A et al. (2018) Approaches to carrier testing and results disclosure in translational genomics research: The clinical sequencing exploratory research consortium experience. Mol Genet Genomic Med 6:898-909
Wolf, Susan M; Amendola, Laura M; Berg, Jonathan S et al. (2018) Navigating the research-clinical interface in genomic medicine: analysis from the CSER Consortium. Genet Med 20:545-553
Amendola, Laura M; Berg, Jonathan S; Horowitz, Carol R et al. (2018) The Clinical Sequencing Evidence-Generating Research Consortium: Integrating Genomic Sequencing in Diverse and Medically Underserved Populations. Am J Hum Genet 103:319-327
Sanghvi, Rashesh V; Buhay, Christian J; Powell, Bradford C et al. (2018) Characterizing reduced coverage regions through comparison of exome and genome sequencing data across 10 centers. Genet Med 20:855-866
Christensen, Kurt D; Bernhardt, Barbara A; Jarvik, Gail P et al. (2018) Anticipated responses of early adopter genetic specialists and nongenetic specialists to unsolicited genomic secondary findings. Genet Med 20:1186-1195
Amendola, Laura M; Robinson, Jill O; Hart, Ragan et al. (2018) Why Patients Decline Genomic Sequencing Studies: Experiences from the CSER Consortium. J Genet Couns 27:1220-1227
Posey, Jennifer E; Harel, Tamar; Liu, Pengfei et al. (2017) Resolution of Disease Phenotypes Resulting from Multilocus Genomic Variation. N Engl J Med 376:21-31
Gutierrez, Amanda M; Robinson, Jill O; Statham, Emily E et al. (2017) Portero versus portador: Spanish interpretation of genomic terminology during whole exome sequencing results disclosure. Per Med 14:503-514
Mody, Rajen J; Prensner, John R; Everett, Jessica et al. (2017) Precision medicine in pediatric oncology: Lessons learned and next steps. Pediatr Blood Cancer 64:

Showing the most recent 10 out of 52 publications