Survivorship is the Focus of New Cancer Genomics Program

Specialized clinic addresses long-term wellness through the study of somatic mutations

A new Cleveland Clinic program aims to integrate research and preventive care to improve the survivorship of patients with newly diagnosed cancers. The novel initiative will use next-generation sequencing to prospectively identify potential therapeutic targets while retrospectively evaluating mutations and other changes that may impact patients’ long-term health.

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The program, which helps patients transition from cancer treatment to recovery while addressing their future risks, is part of Cleveland Clinic Cancer Center’s new CHIP Clinic. The first of its kind in Ohio and one of only a few in the U.S., the clinic screens and monitors patients with clonal hematopoiesis of indeterminate potential (CHIP): somatic mutations in blood or bone marrow cells that increase the risk of blood cancers and heart disease.

Although the new Survivorship Program will initially focus on the study of breast and head and neck malignancies, Taussig Cancer Institute hematologist/oncologist Bhumika Patel, MD, says her team’s goal is to eventually serve patients in all disease groups.

“Genomic testing is already playing a vital role in our ability to target certain cancers, but it is poised to one day become standard care for patients with other chronic disorders,” explains Dr. Patel, who helped establish the CHIP Clinic in 2020. “The Survivorship Program will enable us to collect and interpret meaningful data that can be used to improve disease classification, streamline the identification of available treatments, and more accurately predict patient outcomes.”

Targeted research

In recent years, several large studies of healthy populations have found age-related mutations that are commonly seen in patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia. Dr. Patel says these discoveries inspired the development of the CHIP Clinic.

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Clonal hematopoiesis (CH) is represented by acquired mutations in leukemia-associated genes such as DNMT3A, TET2, ASXL1 and others; however, non-leukemia-associated CH mutations can exist in a small population of blood cells as well. Cleveland Clinic researchers strive to better understand the biology of CH, develop clinical trials and establish guidelines for managing patients with the disorder.

“By studying these mutations in cancer patients, we can learn an enormous amount about the progression of CHIP – knowledge that ultimately benefits our patients through customized interventions, education and preventive care,” explains oncologist Jessica Geiger, MD, who codirects the Survivorship Program.

Patients with newly diagnosed cancers as well as those who have already undergone treatment will be included in the research efforts.

Empowering patients

Dr. Geiger explains that the new program is designed to give cancer survivors a certain level of control over their treatment and long-term wellness.

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“Cancer survivors are often faced with long-lasting or late-onset effects of their disease and its subsequent treatment. Our team has the opportunity to connect patients with the resources they need to address these health concerns head-on and, we hope, achieve an optimum quality of life – now and in the future,” she says.

The Survivorship Program will continue to evolve as cancer treatments improve and more is learned about CH, explains Dr. Patel. She notes that the chance to participate in meaningful research has empowered many of her patients, who are eager to support the recovery of their fellow cancer survivors.

“Our patients are invested in this process; they want to do everything they can to improve their own long-term health and prevent suffering in other cancer survivors,” she says. “As clinicians, we want to do all we can do to mitigate our patients’ risk factors and develop customized, targeted cancer therapies. Ultimately, we are all in this together.”