Lost in translation: Returning germline genetic results in genome-scale cancer research

Background: The return of research results (RoR) remains a complex and well-debated issue. Despite the debate, actual data related to the experience of giving individual results back, and the impact these results may have on clinical care and health outcomes, is sorely lacking. Through the work of t...

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Main Authors: Johns, A., McKay, S., Humphris, J., Pinese, M., Chantrill, L., Mead, R., Tucker, K., Andrews, L., Goodwin, A., Leonard, C., High, H., Nones, K., Waddell, N., Patch, A., Merrett, N., Pavlakis, N., Kassahn, K., Samra, J., Miller, D., Chang, D., Pajic, M., Pearson, J., Grimmond, S., Zeps, Nikolajs, Gill, A., Biankin, A., Chin, V., Chou, A., Steinmann, A., Arshi, M., Drury, A., Froio, D., Morgan, A., Timpson, P., Hermann, D., Vennin, C., Warren, S., Wu, J., Pinho, A., Newell, F., Mukhopadhyay, P., Addala, V., Kazakoff, S., Holmes, O., Wood, S., Xu, C., Hofmann, O., Wilson, P., Christ, A., Bruxner, T., Samra, S., Arena, J., Mittal, A., Asghari, R., Pavey, D., Das, A., Cosman, P., Ismail, K., O'Connnor, C., Williams, D., Spigellman, A., Lam, W., McLeod, D., Nagrial, A.
Format: Journal Article
Published: BioMed Central Ltd. 2017
Online Access:http://hdl.handle.net/20.500.11937/53694
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author Johns, A.
McKay, S.
Humphris, J.
Pinese, M.
Chantrill, L.
Mead, R.
Tucker, K.
Andrews, L.
Goodwin, A.
Leonard, C.
High, H.
Nones, K.
Waddell, N.
Patch, A.
Merrett, N.
Pavlakis, N.
Kassahn, K.
Samra, J.
Miller, D.
Chang, D.
Pajic, M.
Pearson, J.
Grimmond, S.
Waddell, N.
Zeps, Nikolajs
Gill, A.
Biankin, A.
Johns, A.
Gill, A.
Chang, D.
McKay, S.
Chantrill, L.
Chin, V.
Chou, A.
Humphris, J.
Pajic, M.
Steinmann, A.
Arshi, M.
Drury, A.
Froio, D.
Morgan, A.
Timpson, P.
Hermann, D.
Vennin, C.
Warren, S.
Pinese, M.
Wu, J.
Pinho, A.
Pearson, J.
Patch, A.
Nones, K.
Newell, F.
Mukhopadhyay, P.
Addala, V.
Kazakoff, S.
Holmes, O.
Leonard, C.
Wood, S.
Xu, C.
Grimmond, S.
Hofmann, O.
Wilson, P.
Christ, A.
Bruxner, T.
Samra, S.
Arena, J.
Pavlakis, N.
High, H.
Mittal, A.
Asghari, R.
Merrett, N.
Pavey, D.
Das, A.
Cosman, P.
Ismail, K.
O'Connnor, C.
Williams, D.
Spigellman, A.
Lam, W.
McLeod, D.
Nagrial, A.
author_facet Johns, A.
McKay, S.
Humphris, J.
Pinese, M.
Chantrill, L.
Mead, R.
Tucker, K.
Andrews, L.
Goodwin, A.
Leonard, C.
High, H.
Nones, K.
Waddell, N.
Patch, A.
Merrett, N.
Pavlakis, N.
Kassahn, K.
Samra, J.
Miller, D.
Chang, D.
Pajic, M.
Pearson, J.
Grimmond, S.
Waddell, N.
Zeps, Nikolajs
Gill, A.
Biankin, A.
Johns, A.
Gill, A.
Chang, D.
McKay, S.
Chantrill, L.
Chin, V.
Chou, A.
Humphris, J.
Pajic, M.
Steinmann, A.
Arshi, M.
Drury, A.
Froio, D.
Morgan, A.
Timpson, P.
Hermann, D.
Vennin, C.
Warren, S.
Pinese, M.
Wu, J.
Pinho, A.
Pearson, J.
Patch, A.
Nones, K.
Newell, F.
Mukhopadhyay, P.
Addala, V.
Kazakoff, S.
Holmes, O.
Leonard, C.
Wood, S.
Xu, C.
Grimmond, S.
Hofmann, O.
Wilson, P.
Christ, A.
Bruxner, T.
Samra, S.
Arena, J.
Pavlakis, N.
High, H.
Mittal, A.
Asghari, R.
Merrett, N.
Pavey, D.
Das, A.
Cosman, P.
Ismail, K.
O'Connnor, C.
Williams, D.
Spigellman, A.
Lam, W.
McLeod, D.
Nagrial, A.
author_sort Johns, A.
building Curtin Institutional Repository
collection Online Access
description Background: The return of research results (RoR) remains a complex and well-debated issue. Despite the debate, actual data related to the experience of giving individual results back, and the impact these results may have on clinical care and health outcomes, is sorely lacking. Through the work of the Australian Pancreatic Cancer Genome Initiative (APGI) we: (1) delineate the pathway back to the patient where actionable research data were identified; and (2) report the clinical utilisation of individual results returned. Using this experience, we discuss barriers and opportunities associated with a comprehensive process of RoR in large-scale genomic research that may be useful for others developing their own policies. Methods: We performed whole-genome (n = 184) and exome (n = 208) sequencing of matched tumour-normal DNA pairs from 392 patients with sporadic pancreatic cancer (PC) as part of the APGI. We identified pathogenic germline mutations in candidate genes (n = 130) with established predisposition to PC or medium-high penetrance genes with well-defined cancer associated syndromes or phenotypes. Variants from candidate genes were annotated and classified according to international guidelines. Variants were considered actionable if clinical utility was established, with regard to prevention, diagnosis, prognostication and/or therapy. Results: A total of 48,904 germline variants were identified, with 2356 unique variants undergoing annotation and in silico classification. Twenty cases were deemed actionable and were returned via previously described RoR framework, representing an actionable finding rate of 5.1%. Overall, 1.78% of our cohort experienced clinical benefit from RoR. Conclusion: Returning research results within the context of large-scale genomics research is a labour-intensive, highly variable, complex operation. Results that warrant action are not infrequent, but the prevalence of those who experience a clinical difference as a result of returning individual results is currently low.
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institution Curtin University Malaysia
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publishDate 2017
publisher BioMed Central Ltd.
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spelling curtin-20.500.11937-536942017-09-13T16:11:34Z Lost in translation: Returning germline genetic results in genome-scale cancer research Johns, A. McKay, S. Humphris, J. Pinese, M. Chantrill, L. Mead, R. Tucker, K. Andrews, L. Goodwin, A. Leonard, C. High, H. Nones, K. Waddell, N. Patch, A. Merrett, N. Pavlakis, N. Kassahn, K. Samra, J. Miller, D. Chang, D. Pajic, M. Pearson, J. Grimmond, S. Waddell, N. Zeps, Nikolajs Gill, A. Biankin, A. Johns, A. Gill, A. Chang, D. McKay, S. Chantrill, L. Chin, V. Chou, A. Humphris, J. Pajic, M. Steinmann, A. Arshi, M. Drury, A. Froio, D. Morgan, A. Timpson, P. Hermann, D. Vennin, C. Warren, S. Pinese, M. Wu, J. Pinho, A. Pearson, J. Patch, A. Nones, K. Newell, F. Mukhopadhyay, P. Addala, V. Kazakoff, S. Holmes, O. Leonard, C. Wood, S. Xu, C. Grimmond, S. Hofmann, O. Wilson, P. Christ, A. Bruxner, T. Samra, S. Arena, J. Pavlakis, N. High, H. Mittal, A. Asghari, R. Merrett, N. Pavey, D. Das, A. Cosman, P. Ismail, K. O'Connnor, C. Williams, D. Spigellman, A. Lam, W. McLeod, D. Nagrial, A. Background: The return of research results (RoR) remains a complex and well-debated issue. Despite the debate, actual data related to the experience of giving individual results back, and the impact these results may have on clinical care and health outcomes, is sorely lacking. Through the work of the Australian Pancreatic Cancer Genome Initiative (APGI) we: (1) delineate the pathway back to the patient where actionable research data were identified; and (2) report the clinical utilisation of individual results returned. Using this experience, we discuss barriers and opportunities associated with a comprehensive process of RoR in large-scale genomic research that may be useful for others developing their own policies. Methods: We performed whole-genome (n = 184) and exome (n = 208) sequencing of matched tumour-normal DNA pairs from 392 patients with sporadic pancreatic cancer (PC) as part of the APGI. We identified pathogenic germline mutations in candidate genes (n = 130) with established predisposition to PC or medium-high penetrance genes with well-defined cancer associated syndromes or phenotypes. Variants from candidate genes were annotated and classified according to international guidelines. Variants were considered actionable if clinical utility was established, with regard to prevention, diagnosis, prognostication and/or therapy. Results: A total of 48,904 germline variants were identified, with 2356 unique variants undergoing annotation and in silico classification. Twenty cases were deemed actionable and were returned via previously described RoR framework, representing an actionable finding rate of 5.1%. Overall, 1.78% of our cohort experienced clinical benefit from RoR. Conclusion: Returning research results within the context of large-scale genomics research is a labour-intensive, highly variable, complex operation. Results that warrant action are not infrequent, but the prevalence of those who experience a clinical difference as a result of returning individual results is currently low. 2017 Journal Article http://hdl.handle.net/20.500.11937/53694 10.1186/s13073-017-0430-4 http://creativecommons.org/licenses/by/4.0/ BioMed Central Ltd. fulltext
spellingShingle Johns, A.
McKay, S.
Humphris, J.
Pinese, M.
Chantrill, L.
Mead, R.
Tucker, K.
Andrews, L.
Goodwin, A.
Leonard, C.
High, H.
Nones, K.
Waddell, N.
Patch, A.
Merrett, N.
Pavlakis, N.
Kassahn, K.
Samra, J.
Miller, D.
Chang, D.
Pajic, M.
Pearson, J.
Grimmond, S.
Waddell, N.
Zeps, Nikolajs
Gill, A.
Biankin, A.
Johns, A.
Gill, A.
Chang, D.
McKay, S.
Chantrill, L.
Chin, V.
Chou, A.
Humphris, J.
Pajic, M.
Steinmann, A.
Arshi, M.
Drury, A.
Froio, D.
Morgan, A.
Timpson, P.
Hermann, D.
Vennin, C.
Warren, S.
Pinese, M.
Wu, J.
Pinho, A.
Pearson, J.
Patch, A.
Nones, K.
Newell, F.
Mukhopadhyay, P.
Addala, V.
Kazakoff, S.
Holmes, O.
Leonard, C.
Wood, S.
Xu, C.
Grimmond, S.
Hofmann, O.
Wilson, P.
Christ, A.
Bruxner, T.
Samra, S.
Arena, J.
Pavlakis, N.
High, H.
Mittal, A.
Asghari, R.
Merrett, N.
Pavey, D.
Das, A.
Cosman, P.
Ismail, K.
O'Connnor, C.
Williams, D.
Spigellman, A.
Lam, W.
McLeod, D.
Nagrial, A.
Lost in translation: Returning germline genetic results in genome-scale cancer research
title Lost in translation: Returning germline genetic results in genome-scale cancer research
title_full Lost in translation: Returning germline genetic results in genome-scale cancer research
title_fullStr Lost in translation: Returning germline genetic results in genome-scale cancer research
title_full_unstemmed Lost in translation: Returning germline genetic results in genome-scale cancer research
title_short Lost in translation: Returning germline genetic results in genome-scale cancer research
title_sort lost in translation: returning germline genetic results in genome-scale cancer research
url http://hdl.handle.net/20.500.11937/53694