With genetic profiles and genomic targeting increasingly impacting treatment decisions, patients and families would welcome a one-stop place where they can find resources to help unravel all this complex information.
In a podium session at the recent ONS Congress, Cheryl Lynn, BSN, RN, HNB-BC, explained how the Cancer Treatment Centers of America (CTCA) has responded to this need by establishing Centers for Advanced Individual Medicine (C-AIM) at each of their 5 hospitals.
“We recognized that as more and more patients began having genomic testing, there would be a great need for education,” not only for patients but for their family members, said Lynn, who directs the center at their Philadelphia location.
To achieve this mission, center staff members proactively reach out to all patients who have molecular testing orders; those have large-panel (50 or more) genomic testing orders are scheduled automatically for a C-AIM 30-minute consultation.
C-AIM has dedicated hospital space, it’s managed by nurses, and the primary focus is patient outreach and education. The centers offer educational materials both in printed form and video.
“Since opening in 2014, more than 600 patients at my center alone have had some sort of contact from us,” Lynn reported, either face-to-face, a phone call, or an invitation to visit the center.
Importantly, the centers also provide educational information to their clinical stakeholders, and these healthcare professionals, patients, and their guests are always welcome to stop by the centers any time they need precision medicine–related information.
Overall, Lynn said they have found that C-AIM has resulted in better care coordination: “We work very closely with our oncology teams, pathologists, laboratory technicians, and finance departments.
“From the time the medical oncologist enters the order for the genomic test into the patient’s EHR, we track that order.” This includes helping with financial concerns such as precertification, following up on specimen procurement and test turnaround time, delivering the test results to the physicians, and medication acquisition. C-AIM staff members also coordinate with the clinical research departments if there are any mutations identified for which a clinical trial might be an option.
In a nutshell, said Lynn, “We track all the patients who are started on genomic-recommended therapies, and we follow their progress all the way through.” Our most important goal, said Lynn, is to make sure patients are getting these targeted therapies that will likely have some benefit for them.
There are also monthly genomic tumor boards at each CTCA site, and each quarter all sites participate via a virtual genomic tumor board.
Lynn said that since the centers opened, “The process has become much more streamlined. C-AIM has become the hub of precision medicine, and all things related to genomics flow through us.” She added that the oncology care teams know to contact C-AIM with any questions they have about test orders, results, or medication acquisition, and there are plans to implement software systems in the near future to further streamline the process and track outcomes data.
The program also includes a continuing education component for physicians and nurses:
“Continuing education for nurses is paramount,” Lynn stressed. “Traditionally, nurses receive very little formalized education in genetics and genomics, and the learning curve is steep. As more is learned about the presence and implications of genomic abnormalities associated with cancer, nurses need to become more knowledgeable and confident in their understanding and application of these advances in science.
With more accelerated FDA approvals than ever before, many of which requiring companion diagnostics, “this field is constantly changing and evolving,” Lynn concluded.
“It’s very difficult really for anyone to keep up … but we believe having a dedicated center allows us to provide the best care to our patients, leading to better patient outcomes.”