Precision medicine has revolutionized cancer treatment—but only for patients who have access to treatments. Nearly 2 million people in the United States are diagnosed each year with cancer, but access to targeted treatments varies widely, and only about half of the eligible people receive them, said Shellie Ellis, PhD, Associate Professor of Population Health at the University of Kansas (KU) Medical Center. “You can have a drug that is 100% effective for anybody who takes it,” noted Dr. Ellis. “But it’s 0% effective if it never reaches the population for whom it’s intended.”
Shellie Ellis, PhD
Standardized Approach to Genomic Testing
Dr. Ellis was recently awarded a $1.2 million R01 grant from the National Cancer Institute (NCI) to test an intervention she and her colleagues designed known as TEAMSPORT (Multi-TEAM Systems Framework Precision Oncology Reflex Testing). The goal of TEAMSPORT is to create a standardized approach to the ordering of genomic tests, on which precision medicine targeted therapies are based, and adapt it for use in community cancer centers, where most patients with cancer in the United States receive care.
To make genomic testing routine and shorten the turnaround time for results, the TEAMSPORT intervention incorporates reflex genomic testing, based on standardized national guidelines, into the workflow of pathology departments rather than oncology departments. Oncology providers, Dr. Ellis noted, often are not permanent providers in rural communities, but pathology groups usually are. Oncologists also are typically responsible for interpreting results and making treatment decisions, whereas pathologists are responsible for preparing the tumor tissue and figuring out what type of cancer it is, so they may be better positioned to order and manage testing on these tissues.
Another key aim of TEAMSPORT is to create an environment where the surgical, pathology, and oncology teams do not work in siloes, but rather have shared goals. “We are very good at training cancer care providers in their area of specialty, but we do very little to train them how to work across teams to make sure everything we know about a patient’s cancer is communicated and executed across teams of providers,” Dr. Ellis said.
Initially, TEAMSPORT will be implemented at the KU Health System in Kansas City. Dr. Ellis hypothesizes that the intervention will lead to a 25% increase in patients receiving this genomic testing while also reducing the time it takes to test to less than 10 days for most patients. The next step, Dr. Ellis said, would be to implement TEAMSPORT more broadly at community cancer centers.