Key Projects

Targeted Oncology

Panel 162-gene pan-cancer panel. Detective of all classes of genomics alterations including translocations, indels, single point mutation, etc.

Targeted AML Panel

A 63-gene panel clinical assay. Detective of all classes of genomic alterations.

Fusion Detection Panel

A fusion detection panel test for lung cancer.

Cell-Free DNA Screening

Development of a complementary screening procedure to mammograms using a liquid biopsy-based technique that is cost-effective, easy to perform, and can be performed serially over time.

Genomic Evaluation of Immunotherapy in Cancer

Development of molecular and cellular-based signatures necessary to define the immune response in relation to immunotherapy-established clinical outcomes.

Whole Genome Sequencing Genomic Biomarker Discovery

WGS Genomic Biomarker Discovery program endeavors to identify predictive and diagnostic cancer biomarkers by investigating the genomics, and associated clinical outcomes of historical patients.

Tumor Evolution Assessment

This study will provide novel data illuminating the role of tumor heterogeneity and genetic evolution in cancer.

Research Clinic Now Open

On March 7, 2016, the Intermountain Precision Genomics Cancer Research Clinic opened on the Intermountain Medical Center campus as an arm of Precision Genomics, the organization’s comprehensive service integrating cancer research and treatment. The Clinic offers early phase cancer clinical trials and targeted therapies on an outpatient basis, giving patients with advanced or rare cancers greater access to new and promising treatments.

The Clinic also has the capacity to house investigator-initiated studies championed by internal, physician researchers to further expand treatment knowledge, specifically for cancer research projects. By participating in cutting-edge clinical trials and research while focusing on enhancing cancer care delivery, the Precision Genomics Cancer Research Clinic is working to improve care for cancer patients in the Salt Lake Valley, throughout Utah, and across the nation.

We have conducted extensive research focused on improving cancer outcomes through a targeted treatment approach. Our respected team continues to identify opportunities to improve how we sequence genes and isolate abnormalities hidden with the chromosomes, and how we respond to findings through personalized, cancer-specific treatment plans. The Precision Genomics team’s research has been featured in many leading healthcare and news publications.

Patients interested in participating in clinical trials may contact the Cancer Research Clinic.  Industry sponsors are welcome to contact Intermountain Precision Genomics headquarters.

ABSTRACTS FROM RESEARCH

"Precision Medicine Improves Survival Without Increasing Costs in Advanced Cancer Patients"

Journal of Clinical Oncology® — The Official Journal of the American Society of Clinical Oncology®


Background

The advent of Next-Generation Sequencing (NGS), and other diagnostic technologies, has enabled the use of genomic information to guide targeted treatment in cancer patients. The outcomes and costs associated with the implementation of precision cancer medicine have been difficult to generate. Leveraging the advantages of an integrated healthcare system, we have implemented a clinical cancer genomics program to personalize targeted treatment for advanced cancer patients in a community setting. We report a retrospective analysis of the clinical outcomes associated with precision cancer medicine.

Methods 

We conducted a matched cohort study of 72 patients from July 2013 to December 2014, with metastatic cancer of diverse subtypes. The outcomes of 36 patients treated with precision cancer medicine were compared to 36 historical control patients who received standard chemotherapy. Study and control patients were matched according to age, gender, histological diagnosis, and number of previous treatment lines. PFS was compared between the two groups using a Cox Proportional Hazard model for survival and accounting for potential confounders. Costs includes ED visits, hospitalizations, NGS costs and costs for targeted or standard therapy. 

Results 

Progression free survival was 22.9 weeks for the treatment group and 12.0 weeks for the historical control group (p = 0.002). Patients receiving precision cancer medicine compared to conventional treatment patients had a hazard ratio of 0.47 (95% confidence interval of 0.29-0.75) when adjusting for age, gender, histological diagnosis and previous treatment lines. Costs per week were $3,204 in the targeted group and $3,501 in the control cohort (p = 0.382). 

Conclusions

Precision cancer medicine appears to significantly improve survival for patients with advanced cancer when compared to control patients who received conventional chemotherapy. The additional survival is not associated with increased costs. While the results of this study warrant further investigation in the setting of a prospective randomized control trial, this genomics-based approach appears to be a viable, and perhaps superior, option for patients with advanced or metastatic cancer. 

Authors: Lincoln Nadauld, S. Burke Van Norman, Gail Fulde, Justin G. McDermott, David Newman, Allison M. Butler, Brian P. Tudor, Heather Gilbert, Karen Yin Lin, Gary Stone, James M. Ford, Derrick S. Haslem; Intermountain Healthcare, St George, UT; Intermountain Healthcare, Salt Lake City, UT; Stanford University School of Medicine, Stanford, CA 

e17641, Journal of Clinical Oncology, 2015, Vol 33 (suppl; abstr e17641) 


"Implementation of a Precision Cancer Program in an Integrated Health Care System"

Journal of Clinical Oncology® — The Official Journal of the American Society of Clinical Oncology®

Background

The advent of Next-Generation Sequencing (NGS), and other diagnostic technologies, has enabled the use of genomic information to guide targeted treatment in cancer patients. Barriers to implementation of a precision cancer clinic in a community setting include ability to perform appropriate NGS testing, interpretation of results, and drug procurement. Leveraging the advantages of an integrated healthcare delivery system, we implemented a precision cancer program for advanced cancer patients in a community setting. This program includes NGS testing, interpretation by a multi-institutional Molecular Tumor Board (MTB) and a drug navigation process. 

Methods 

In July 2013, we began seeing metastatic cancer patients who had failed standard treatments in our precision cancer clinic. Patients with a good performance status and ability to consent were eligible. NGS was performed on fresh or archival tissue and each case was presented at our MTB which consists of experts in oncology and cancer genomics. Recommendations from the MTB were given to the treating physician, who then discussed with the patient. If it was decided to treat with the new agent, a drug navigation specialist worked with payers to obtain the drug, sometimes resulting in a complex appeals process. Patients were monitored for survival outcomes, cost and adverse events. 

Results 

To date, 243 patients with a variety of tumor types have had NGS performed on their tumor as part of our precision cancer clinic. 188 patients (77%) had actionable mutations. This resulted in a treatment change to the targeted drug in 117 patients (62%). In addition, 38 patients (20%) have targeted options available, but are awaiting disease progression through their current treatment. Our drug navigation system has successfully obtained drug for 155 patients (82%) through insurance approval, appeals processes or clinical trials. 

Conclusions 

Although barriers to precision cancer clinics exist, they can be overcome in the community setting through appropriate implementation of NGS, access to a MTB and a drug procurement process. In the era of personalized medicine, this model offers improved access to genomic medicine for advanced cancer patients outside of the academic setting. 

Authors: Lincoln Nadauld, Derrick S. Haslem, Gary Stone, Pravin J. Mishra, Sharanya Raghunath, Jason L. Gillman, David L. Loughmiller, James M. Ford; Intermountain Healthcare, St George, UT; Intermountain Healthcare, St. George, UT; Stanford University School of Medicine, Stanford, CA 

e17647, Journal of Clinical Oncology, 2015, Vol 33 (suppl; abstr e17647)