Implementation of a Pediatric Oncology Precision Medicine Clinic to Personalize Approaches for Diagnosing and Treating Solid Tumors.
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BACKGROUND: Precision medicine is an emerging approach for treating pediatric cancer due to its ability to target tumor-specific genetic drivers rather than provide broad and aggressive treatments. The study aimed to outline the establishment and impact of a Precision Medicine Clinic (PMC) in the setting of pediatric oncology, with the objective of offering targeted treatment options within the institution and creating a scalable model for adoption by other healthcare systems to achieve a wider impact. METHODS: Recognizing this need for an individualized approach to treating patients, Cook Children's Medical Center (CCMC) established a multidisciplinary molecular tumor board in 2019, followed by the launch of an official PMC in 2021. Before this, there was no dedicated place to discuss and evaluate genetic sequencing results. RESULTS: In 2022 and 2023, the PMC discussed 69 patients with a wide variety of oncologic diagnoses. Through the clinic's efforts, 133 genetic variants across 101 genes have been identified, spanning oncogenic pathways related to cell cycling, DNA processing, and cell signaling. Of the sequenced patients, four have received targeted therapy according to recommendations from the PMC. CONCLUSION: While the PMC continues to evaluate patients and their long-term outcomes, the continually growing PMC at CCMC represents the beginning of the advancement of treating pediatric oncology patients through the interpretation of genetic sequencing results, making actionable targeted treatment recommendations, and continuing to follow the patient's course of care over time. This additionally provides a framework for starting a PMC that can be adapted for specific clinical needs and implemented broadly.