Am I eligible for an extensive DNA test?

Customized treatment

The extensive DNA test of Hartwig Medical Foundation visualizes all characteristics of the tumor DNA, whereby a (more) complete image of possibilities for patient treatment arises. This way the chance the patient receives the right treatment increases, or the DNA test shows that a certain type of drug possibly does not work at all or less properly. Besides the customized treatment which are given in the ‘standard of care’ today, the extensive DNA test also brings out all possible options for participation in current experimental clinical studies.

Patïënt rapport-voorbeeld-1e-pagina

Patient report example 1st page

The extensive DNA test

  • analyses the entire DNA of the tumor through whole genome sequencing (WGS);
  • identifies all changes in the tumor DNA with possible leads for customized treatment;
  • results in a clear patient report;
    • containing possible treatment options with existing, registered onco drugs which correspond to the found DNA deviations;
    • containing a list of possible experimental medications (off label) (Dutch) and;
    • containing options for current clinical studies.

For whom is the extensive DNA test?

This DNA test is suitable for all adult patients with metastasised cancer (except leukaemia) provided that a sample of the tumor can be taken safely.

Present day cancer care for patients already encompasses several (molecular) diagnostic tests, including DNA tests. These tests usually focus on a (more limited) number of DNA characteristics of the tumor and only for a limited number of cancer.

Patients who no longer have a treatment option and patients suffering from a rare type of cancer for which no standardised treatments are available, benefit most from this extensive DNA test.

Consultation with the treating specialist is always required in order to establish whether the extensive DNA test can be beneficial for a patient.

Extensive DNA test as part of clinical studies

The extensive DNA test is already used for two clinical studies in The Netherlands; more precisely the CPCT-02-study and the WIDE-study. This last study is carried out in cooperation with the Antoni van Leeuwenhoek Hospital (Dutch). With the study requirements at hand the treating specialist will be able to determine whether it is possible or useful for the patient, who is already treated in one of the participating hospitals, to participate in the clinical study in question.

Extensive DNA test not part of the studies

Patients who no longer have a treatment option and patients suffering from a rare type of cancer for which no standardised treatments are available, but who do not meet the requirements of the studies mentioned above, might still be eligible for the extensive DNA test. For example in a second opinion procedure.

Second opinion

In consultation with the treating specialist, a referral to the Erasmus MC (Rotterdam) for a second opinion can be requested. The second opinion procedure evaluates the benefit of an extensive DNA test for the selection of treatment options in a clinical study setting. This will be discussed with the patient.

Erasmus MC also has a Cancer Instite. More general information can be read on their website. 

Information for the treating specialist

Tumor tissue taken in routine procedures in hospitals is quite often not suitable for the extensive DNA test of Hartwig Medical Foundation. Immediately after the tumor tissue is taken it has to be stored in a specific manner (freshly frozen).

In The Netherlands 44 hospitals are familiar with this storage procedure. Hartwig Medical Foundation can answer any questions about the required procedures of the extensive DNA test.

The procedure of this DNA test consists of several steps:

  1. taking a fresh tissue sample and patient’s blood at a hospital;
  2. shipping of the tissue sample and blood to Hartwig Medical Foundation;
  3. a quality check establishes whether sufficient tumor material is present in the tissue sample to be able to do the extensive DNA test;
  4. isolation of the DNA from tissue sample and blood;
  5. processing of the isolated DNA;
  6. reading and mapping the entire DNA of the tumor and blood;
  7. data-analyses: software searches for tumor specific deviations in the DNA of the tissue;
  8. interpretation of the DNA analyses and data which may be relevant for the treatment is interpreted for possible therapy and / or participation in a study;
  9. conclusion of the data in a patient report;
  10. check of the patient report by a clinical molecular biologist;
  11. sending the digital patient report to the treating specialist, for further interpretation and discussion with the patient.

Questions?

If you as a patient or a doctor have any general questions about the extensive DNA test or its application or you wish to have more information about the options to participate in one of the above studies please contact Hartwig Medical Foundation. Preferably send your questions by e-mail, but you may also call us on 020 – 235 2640.

Watch this video: The right treatment for each cancerpatient (Dutch video, with English translation)

Accreditation and standardisation

Novaseq 6000

Hartwig Medical Foundation has carried out the extensive DNA test in its laboratory since the end of 2017, for which we have an ISO17025 accreditation. Click here for the scope of this accreditation. The performance of data analysis and data storage is in accordance with NEN7510 (Dutch). The extensive DNA test is validated and has by now been carried out for more than 4,000 patients in various Dutch studies.