In your opinion, which response best characterizes the future state of predictive cancer genomics:
In 2020, most germline cancer genetic testing will be delivered
By cancer genetic health care professionals using traditional forms of genetic counseling
By a variety of health care professionals ordering tests on-line, with blood or saliva samples sent and results received online or in person, and reimbursed by carriers.
By individuals via direct-to-consumer testing, largely self-paid, with results discussed with a health care provider only if initiated by the consumer
In the context of treatment selection, limited by third party payers, and with results delivered as any other medical test.
By 2020, the assessment of the patient newly diagnosed with cancer, for largest number of cases, will include
Tumor only testing for mutations that are shown to target therapies
Tumor-normal testing including germline risk assessment at the same time
Tumor-normal exome/genome/transcriptome testing with reporting of all inherited findings, including non cancer risks
By 2020, pre-implantation genetic diagnosis for cancer predisposition
Will be used at about the same frequency as today
Will be used much more often and reimbursed by carriers
Will begin to be impacted by direct germline “editing,” prohibited in the U.S, but obtained abroad.
Will be routinely included as part of “fitness” screens offered to all reproductive age couples, with defined indications for reimbursement by carriers
By 2020, pharmaco-genomic testing for cancer drug and dose selection
Will be utilized uncommonly as drug choices and dosing will be based on other factors
Will be routinely performed as part of pretreatment assessment of the cancer patient
Will be performed commonly but after initiation of treatment in the assessment of severe toxicity in selected cancer patients
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