Dr. Shields Discusses the Prevalence of Genetic Testing in CRC

Anthony Shields, MD, PhD
Published: Wednesday, May 08, 2019



Anthony Shields, MD, PhD, oncologist, Department of Oncology, Molecular Imaging and Diagnostics Program, Barbara Ann Karmanos Cancer Institute, discusses the prevalence of genetic testing in colorectal cancer (CRC).

Genetic testing is done in virtually every patient now, Shields says. Even early-stage patients will be tested for mismatch repair proficiency. This may not change the way an oncologist treats a patient with early-stage CRC, but it certainly impacts the way the patient is monitored. At a minimum, patients with all stages of CRC should be tested for mismatch repair defects.

In stage IV disease, multi-gene panels are utilized for genetic testing. While these technologies are expensive, they are not dissimilar to the cost of 1 dose of standard therapy, Shields notes. It becomes worthwhile when a physician is able to identify whether a certain approach will or not work in a patient. While these gene panels are expanding, Shields expects full sequencing of DNA to be performed in the near future. Detectable alterations like NTRK and RET are extremely rare, but they can transform treatment for a patient.
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Anthony Shields, MD, PhD, oncologist, Department of Oncology, Molecular Imaging and Diagnostics Program, Barbara Ann Karmanos Cancer Institute, discusses the prevalence of genetic testing in colorectal cancer (CRC).

Genetic testing is done in virtually every patient now, Shields says. Even early-stage patients will be tested for mismatch repair proficiency. This may not change the way an oncologist treats a patient with early-stage CRC, but it certainly impacts the way the patient is monitored. At a minimum, patients with all stages of CRC should be tested for mismatch repair defects.

In stage IV disease, multi-gene panels are utilized for genetic testing. While these technologies are expensive, they are not dissimilar to the cost of 1 dose of standard therapy, Shields notes. It becomes worthwhile when a physician is able to identify whether a certain approach will or not work in a patient. While these gene panels are expanding, Shields expects full sequencing of DNA to be performed in the near future. Detectable alterations like NTRK and RET are extremely rare, but they can transform treatment for a patient.

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