Cleveland Clinic expands capabilities in cancer genomic testing

Cleveland Clinic has expanded its cancer genomic testing capabilities in order to better understand a patient's cancer and identify potential therapeutic targets, according to a news release.

The system now offers an advanced genomic testing platform as standard of care for patients with cancer, an expanded capability to test tumor samples. It involves whole exome sequencing, which examines all portions of DNA in the genes that are responsible for making proteins in the body, and RNA sequencing that assesses how these proteins are encoded, according to the release.

Combined, this provides a comprehensive snapshot of defects that may drive the growth of cancer, helping clinicians connect patients with individualized treatment in the hope of improved outcomes and quality of life.

The ability to sequence and analyze more genomic data allows the Clinic to access and interpret tumor complexity, and the new technology enables researchers to examine 22,000 genes in the human genome, which is the most extensive profiling available today, according to the release, which notes that previous testing was limited to 600 or fewer known genes associated with cancer.

"Industry-leading tumor profiling coupled with our precision oncology initiatives and developmental therapeutics programs give our patients greater access to the latest potentially lifesaving options," said Dr. Timothy Chan, director of the Center for Immunotherapy and Precision Immuno-Oncology at the Clinic, in a provided statement "This technology is a critical new tool for physicians to develop individualized treatment plans for patients based on their unique genomic profile."

It also offers an opportunity for patients to learn about their disease and participate in precision oncology-driven clinical trials, Chan said in the release, which notes that clinical trials underway at the Clinic are testing treatments that may impact the genetic alterations revealed by tumor genomic testing.

A team at University Hospitals Harrington Heart & Vascular Institute became the first in the United States to report a safer, minimally invasive strategy for removing infections in the heart associated with right-sided infective endocarditis, according to a news release from UH.

The new strategy — published in Catheterization & Cardiovascular Interventions, a journal from the Society for Cardiovascular Angiography & Interventions — treats the infection using the Triever system with FLEX technology, which was originally designed to treat pulmonary embolism, according to the release.

Conducted in the catheterization lab on an awake patient, the novel procedure uses intracardiac echocardiography and fluoroscopy guidance, eliminating eliminates the need for an uncomfortable tube (transesophageal echocardiography) down the patient's throat, according to the release.

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Mehdi Shishehbor — president of UH Harrington Heart & Vascular Institute and the Angela and James Hambrick Master Clinician in Innovation — and his team of interventional cardiologists and cardiac surgeons have completed more than a dozen successful cases at UH Cleveland Medical Center.

"The beauty of using the Triever technology for this purpose is that it can be done on an awake patient, does not require a heart-lung machine, does not require general anesthesia and the procedure takes about 20 minutes," said Shishehbor — who, with his colleagues, has launched a multisite registry to further evaluate the intervention — in a provided statement. "I was optimistic that given my experience, we'd be able to use this new Triever technology in a much safer way, less intensive way, to be able to clear infections. We first offered it to a patient who was not a good surgical candidate, and we were surprised at how effective it was."

This type of heart infection is commonly treated using two "less-than-ideal" surgical and interventional options, according to the release: open-heart surgery (which is invasive and requires significant recovery) and AngioVac (which requires general anesthesia in the operating room, as well as a full heart and lung machine).

"This is a true revolution in treating these patients," said Dr. Yasir Abu-Omar, director of cardiothoracic transplantation and mechanical circulatory procedures at UH, in a statement. "We no longer have to go directly to surgery. We can try this approach first, treat the infection, get the patients discharged from the hospital and get them into substance abuse therapy. If they're doing well, then no further surgery is needed. However, if we confirm they need an operation, we can offer that after rehabilitation. It's a true paradigm shift."

This story was first published by our sister publication, Crain's Cleveland Business.