January 29, 2019

Clinical NGS initiatives: making an impact with sequencing

By Cytiva

As next-generation sequencing (NGS) makes inroads into clinical applications such as cancer diagnostics, we look at some of the NGS initiatives and collaborations aiming to change the landscape of clinical sequencing and improve patient’s lives.

In December 2018, Genomics England announced that they had reached the main goal of their ambitious “100 000 Genomes Project”—to sequence 100 000 genomes. The results are already making an impact on the lives of people with cancer and a range of other diseases.

The aims of Genomics England aren’t unique. All over the world, huge NGS initiatives and collaborations are launching or ongoing—all aiming to advance our understanding of genomics and improve patients’ lives through the power of DNA sequencing.

We look at the status of next-generation sequencing (NGS) in the clinic in our white paper. Here, we’ve picked out some of the DNA sequencing initiatives, where today’s scientists work together to change outcomes for patients tomorrow. Who are they, and what are trying to achieve?

100 000 ways to improve molecular diagnostics

One of the key aims of the 100 000 Genomes Project is to provide diagnostic tools for patients with rare diseases: those that have been difficult to diagnose in the past. These patients have often gone through ‘diagnostic odysseys’ as doctors struggled to uncover a cause for their condition.

Launched in 2013, the 100 000 genomes project didn’t just look at DNA containing harmful mutations, it also created healthy reference genomes. Cancer patients, for example, had both their healthy and tumor DNA sequenced. For inherited diseases, the project used parental genomes for comparison.

Genomics England expects to present the final results to the UK’s National Health Service (NHS) in 2019. But early results from this NGS initiative have already identified causative mutations in patients with previously undiagnosed conditions, enabling more targeted treatments and often ending years of uncertainty.

Setting the standard for cancer diagnostics

As the use of clinical NGS expands and the number of available genetic tests increases, there’s an emerging need for improved standardization and regulatory oversight.

One collaboration that’s working on addressing this issue in the field of cancer sequencing is the Actionable Genome Consortium. Its central goal is to work towards a clearer definition of an ‘actionable cancer genome’. It aims to set out clear standards that define tumors (and their treatments) by genetic makeup.

The collaboration began in 2014 and involves sequencing giant Illumina and four major US cancer centers: the Dana-Farber Cancer Institute, the Fred Hutchinson Cancer Research Center, the MD Anderson Cancer Center, and the Memorial Sloan Kettering Cancer Center.

The added value of this collaboration is that these major cancer centers have large, multidisciplinary cancer boards. Their know-how can help other clinicians working in cancer diagnostics assess the clinical significance of complex NGS data.

This collaboration is also already having an impact on the way organizations develop new sequencing panels.

Assessing the broader impact of clinical NGS

When it comes to gathering clinical sequencing data, the central paradigm is often “more is better.” But this quest for retrieving more and more information about our genomes overlooks a concern that many people have in our society: does more information always improve well-being?

This concern is one of the aspects of sequencing that the BabySeq project is investigating. BabySeq is a randomized clinical trial, in which scientists are sequencing the genomes of around 150 babies in the treatment group and comparing to a control group where no sequencing takes place.

The aim of this approach is to investigate the broader impact of whole genome sequencing on the well-being of both babies and their parents. Alongside data on the babies’ health and the care they receive, the research also considers answers received from questionnaires given to parents about how access to their child’s genetic information affects their family life.

Researchers hope to use this information to gain an insight into the effects of DNA sequencing that might otherwise be overlooked with a purely clinical approach.

These are a few examples of NGS initiatives where clinical research using sequencing is telling us about more than just the mutations we have in our genes. Read our white paper for more information on current trends and applications of clinical NGS.

At Cytiva, we provide a broad product range to support DNA sequencing workflows. To find out more about optimizing your DNA sequencing, or for support in any aspect of your workflow, contact Cytiva Scientific Support or your local Cytiva representative.