Cancer is still one of the leading causes of death in Canada. When abnormal cells develop and multiply, they prevent vital organs, nerves and blood vessels from functioning the way they should. That, in a nutshell, is what takes place when one has a cancer. There is however some hope on the horizon in the form of cancer tailored pharmacogenetic testing.

“The earlier, the better” is pretty much the rule with cancer. Early detection and early treatment. As an example, with lung cancer, the leading cause of cancer in Canada, the 5 year survival rate is 22%.

However, 90% of patients will survive at least a year if they are diagnosed at the earliest stage. This drops to 20% when diagnosed at the latest stage of lung cancer. Unfortunately, the signs don’t always appear in the early stages which presents one major challenge.

Cancer Tailored Pharmacogenetic Testing

With respect to treatment, the challenge is in matching the right treatment with the right patient. They’re not all the same and people respond differently to different treatment. It’s not just about side effects, it’s also about ineffectiveness.

And while doctors go through the steps of trying a treatment and waiting for results, the clock continues to tick away, and the wrong treatment means that the cancer continues to do its damage. Pharmacogentics to the rescue.

Pharmacogenomics is a quickly developing field of study that researches how drug response is linked to a person’s genetics. As each one of us has our own unique, individual genetic makeup, so too is our individual response to medication. That response can vary from ineffective to effective and everything in between, depending on our DNA or genetic composition. 

Where to Find Cancer Tailored Pharmacogenetic Testing

Application of this field for consumers means providing tests to profile your genes, which can then be analyzed by a health professional. The profile can indicate which treatment is appropriate for you, based on how your body will react to it.

When it comes to cancer, hundreds of compounds in cancer medications have a potential correlation to specific genetic markers. Improving patient safety and care through effective treatment is an area where pharmacogenetic testing is now helping.

This type of genetic testing is now available to Canadians in their fight against cancer, and below are just a few of the available tests that can aid your physician team in choosing the right treatment protocol.

Where can Canadians Get Cancer-Tailored Pharmacogenetic Testing?

Guardant Health offers a pharmacogenetic test that produces a thorough gene profile on over 70 genes and any genomic alterations which act as indicators of response and resistance to specific drugs.

The Oncotype Dx test was created for people recently diagnosed with invasive breast cancer to identify the chance of it growing or returning, as well as the best treatment options.

GO-PGx helps children diagnosed with cancer by minimizing the adverse drug reactions (ADRs) that coincide with the strong medications.

Guardant Health

Guardant Health offers Guardant360, a pharmacogenetic test that produces a thorough gene profile using blood samples. The test entails drawing two 10mL blood samples to be laboratory tested for tumour DNA shed into the bloodstream.

Within 7 days, doctors will receive their patient’s report which includes their gene profile on over 70 genes and any genomic alterations which act as indicators of response and resistance to specific drugs. The report will also list any relevant therapies and drugs still in clinical trials, helping physicians choose the optimal cancer treatment for their patients.

Guardant360 can be ordered by patients or by healthcare professionals. The test is intended to be analyzed by doctors of patients whose cancer is progressing on their current medication or have received incomplete or inconclusive results on their initial tumour tissue biopsy.

To order the test and learn about pricing, individuals must call or email Guardant Health’s Client Service team. Guardant Health claims that Guardant360 is covered by most insurance companies.

Visit Guardant Health’s website to learn more about their cancer tailored pharmacogenetic testing:

https://guardanthealth.eu/

Read Guardant360’s patient brochure to learn more about the test:

https://guardanthealth.ca/files/Guardant360-Patient-Brochure

Exact Sciences: Oncotype Dx Breast Cancer Test

The Oncotype Dx test was created for individuals who have been recently diagnosed with invasive breast cancer. Using tissue from your tumour, the diagnostic test uses your genes to identify the chance of it growing or returning. It will also identify the best treatment option for you and can indicate whether chemotherapy would be effective. 

The test must be ordered by your doctor or another licensed health professional. Oncotype Dx is publicly funded in all Canadian provinces for individuals who have been diagnosed with early stage node negative breast cancer.

Individuals diagnosed with node positive breast cancer are covered by public funding in the following provinces: British Columbia, Saskatchewan, Manitoba, Ontario, Quebec, New Brunswick, PEI and Newfoundland.

Outside of these provinces, individuals may be required to pay themselves. Inquiries on potential payment and additional details can be answered by contacting them here: https://www.oncotypeiq.com/en-CA/contact/contact-us

Visit Exact Sciences’ website to learn more about the Oncotype Dx Breast Cancer Test: https://www.oncotypeiq.com/en-CA/breast-cancer/patients-and-caregivers/stage-i-iiia-invasive/about-the-test

Genome British Columbia: GO-PGx

GO-PGx is an ongoing University of British Columbia (UBC)-affiliated project created in 2017 led by Dr. Bruce C. Carleton and Dr. Colin J. Ross. The purpose of the project is to help children diagnosed with cancer by minimizing the adverse drug reactions (ADRs) that coincide with the strong medications.

The ADRs that can develop in cancer patients are influenced by genetic factors, so by developing a pharmacogenetic test specifically for cancer medications, the lives of many children can be improved and saved.

The project entails using GO-PGx to analyze 6,125 DNA samples and cancer medications to formulate ADR outcome data. The data will reveal the biomarkers that indicate the genetics that may be more susceptible to ADRs. This will allow physicians to predict the development of an ADR in a young cancer patient before it occurs.

With their data, Dr. Carleton and Dr. Ross plan to educate physicians and patients as well as implement GO-PGx into clinical practices starting with 10 Canadian pediatric cancer centers. The two also plan to create a database for researchers to access clinical and genetic data plus publish peer-reviewed clinical practice guidelines within one year of the project’s conclusion. 

Visit Genome British Columbia’s website to learn more about GO-PGx: https://www.genomebc.ca/projects/genomic-and-outcomes-databank-for-pharmacogenomic-and-implementation-studies-go-pgx

Pharmacogenetic testing is still in its earlier stages of adoption. In the near future, these tests will be much easier for Canadians to access. In the interim, we encourage Canadian health consumers who need it to raise the question with their doctors to learn more about its potential for your treatment and recovery.

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