When it comes to patient care, there is often a delicate balance between timeliness and comprehensiveness. Indeed, many of the diagnostic tools used in patient care require time to deliver cutting-edge information.
This notion was top of mind for a collaborative team of clinicians, pathologists and scientists from BWH and Dana-Farber Cancer Institute, who recently came together to develop and deploy a new molecular test to detect genes that are frequently mutated in blood cancers.
The test, known as the Rapid Heme Panel, was launched this summer and has already been used to guide the care of more than 100 patients at Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC). The test simultaneously screens for 95 genes frequently mutated in blood cancers using powerful DNA sequencing technology deployed in-house at DF/BWCC. Test results are typically returned within a week—a rapid turnaround compared to other comprehensive, next-generation sequencing-based tests.
The test is available for use in adult patients with leukemia, myelodysplastic syndromes—disorders caused by poorly formed or dysfunctional blood cells—and myeloproliferative disorders, which cause blood cells to grow abnormally in bone marrow. The team hopes to soon expand the test to include other blood cancers.
Prior to the new Rapid Heme Panel, vials of blood from newly diagnosed patients were sent to multiple outside laboratories for different types of testing, including separate tests for three genes commonly mutated in these disorders. These tests could take weeks to deliver results.
“It’s simply not something that is acceptable for patients with acute leukemia, who are some of the sickest patients with some of the most aggressive cancers that we see,” said Jon Aster, MD, PhD, director of Hematophathology at DFCI and BWH, and one of the team members who helped develop the Rapid Heme Panel.
In addition to its relatively quick turnaround time, the wide spectrum of genes on the Rapid Heme Panel often allows physicians to deliver a more precise diagnosis and prognosis. In some cases, timely information about disease mutations can help determine the best course for therapy. This may be a standard therapy or, in the new era of precision medicine, this could be a clinical trial of a novel drug that targets a particular mutation within a patient’s blood cells.
A multidisciplinary team worked tirelessly to bring the Rapid Heme Panel into the clinic, including Aster and Richard Stone, MD, program director of the Adult Leukemia Program at DF/BWCC. Frank Kuo, MD, PhD, of the Center for Advanced Molecular Diagnostics, drove the development of the powerful informatics needed to analyze and deliver test results to clinicians. He also worked out the details of the complex biochemistry that underlies the test. Kuo worked closely with Michael Kluk, MD, PhD, and Coleman Lindsley, MD, PhD, who created the analytic workflow that helps ensure accurate, robust results.
“We developed this test with the goal of changing clinical practice,” says Kuo. “Some of our clinical colleagues are telling us that is already happening, which is incredibly exciting.”