Oncology Nurses Can Be Advocates for Next-Gen Sequencing


Next-generation sequencing may better predict dMMR in patients with colorectal or endometrial cancer, highlighting the importance of the testing.

Oncology nurses have an important role of spreading awareness — to both patients and doctors — about the potential benefit of next-generation sequencing, according to Amin Nassar, MD.

Nassar, a clinical fellow at Yale School of Medicine, and colleagues recently published research that found that more patients with endometrial or colorectal cancer were able to have their DNA mismatch repair deficiency (dMMR) status detected with next-generation sequencing than with immunohistochemistry testing. Considering the dMMR status indicates whether a patient would be eligible for immunotherapy treatment, it is important that this group of patients be identified.

MORE:Pembrolizumab Receives Full FDA Approval for Treatment of Select Patients With dMMR/MSI-H Solid Tumors


A lot of the sequencing platforms that we do, the nurses are really familiar with. The reason being is, they're the ones who draw the blood for match sequencing. They're the ones to ping and follow up with the commercial companies, so they're really like the pioneers in terms of like pushing for this data. So I think [nurses have a role] in terms of awareness, raising awareness about the importance of doing next-gen sequencing early on, for this, and also advocating with the clinicians, for their patients about this.

Because, I think, immunohistochemistry is routine, you almost don't have to think about it, it's done automatically by the pathologist right away—the clinician doesn't even have to think about it, the nurse doesn't have to. As soon as they get the tumor, it's done right away.

[Regarding] next-gen sequencing right now, because the nurse is the one, as I said, was the first line of defense —I would say, raising awareness with for the physician with the patient to and telling the patient, “This is this is actually something that's exciting, it's increasing detection rate [for dMMR]. You should read more about it,” for example. And the telling the physician, basically that we're seeing more and more sensitive tests to detect mismatch repair deficiency; is it worth moving next-gen sequencing earlier, in terms of this patient's testing? The clinician, then, I think we'll have to evaluate and think what the best step is, but I think, you know, definitely, from a nurse perspective, raising awareness and communicating with the physician and the house staff about this.

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