Genomic testing: Cutting-edge cancer care denied to thousands

People with advanced cancer who have run out of treatment options are missing out on cutting-edge genomic testing, or being forced into financial ruin to fund it themselves. Now there is a proposal that offers hope and will save lives.

More than 30,000 people with advanced cancer are being denied access to cutting-edge genomic screening that can match their cancer to targeted drugs that will extend or even save their lives.

While a funded trial is under way at the Garvan Institute, patients like Alison Day, 52, have to pay $10,000 for the molecular testing to find out what medications may buy them more time.

The advances and clinical treatments offer hope but too few have access according to Richard Vines, co-chair of the National Oncology Alliance.

“For patients who have advanced cancer, right now the only way for those people getting tested is through clinical trials like the MoST (Molecular Screening and Therapeutics) trial which is maybe doing 1000-1500 people a year and all the rest have to pay,” he said.

“There are overseas organisations that are doing testing, but I would guess thousands are paying for it.”

Mother of two Alison Day has triple negative terminal breast cancer. Picture: Toby Zerna

Ms Day, who is the mother of two young daughters, has metastatic breast cancer and has been given between two and 18 months to live.

She paid $10,000 to a US company to have her cancer tested but the drug most promising for her cancer is not available in Australia.

Another promising drug that will buy her time is subsidised by the PBS for melanoma but not for breast cancer, so Ms Day is having to pay full-price for the drug Keytruda.

“Fundamentally there is an inequity in the access to genomic screening and we have a system that guarantees these people will never get access to these drugs. If we could solve this problem lives will undoubtedly be extended or saved,” Mr Vine said.

Professor David Thomas from The Garvan Institute established the Australian Genomic Cancer Medicine Centre in 2018 to run genomic testing and matched therapies. He now heads up Omico, a non-profit, national cancer network, providing precision oncology based on genomic testing.

The Garvin Institute’s Professor David Thomas said more Aussies could benefit from genomic testing. Picture: Supplied

Omico has proposed the federal government fund a National Genomic Medicine Platform to allow up to 80,000 Australian late-stage cancer patients access comprehensive genomic profiling in addition to clinical trials to access novel therapies.

Personalised therapies based on the existence of specific biomarkers within patients offer hope for better cancer treatments and are expected comprise about 80 per cent of the global oncology treatment market within two years.

“We estimate about 35,000 Australians a year could benefit from genomic screening and matched therapy,” Prof Thomas said.

The proposal, put forward for consideration in the upcoming budget, is based on government support for genomic screening will attract global investment in clinical trials in Australia.

“We want to link government support for universal screening to industry support to bring more trials to this country because the government is prepared to do the screening,” he said.

“For about $280 million over five years of federal government investment, we hope to bring in about $2.8 billion in pharmaceutical investment which will create jobs and save lives.”