A Generalizable, Governance-Embedded Pathway for Assessing Patient-Level Opportunities for Genetic Medicines
Cheerie, D.; Pan, A. Y.; Acker, M.; Amburgey, K.; Sidhu, J.; Buckley, L.; Gonorazky, H.; McKinnon, N. K.; McRae, L.; Reuter, M. S.; Vogt, L.; Zahavich, L.; Czarny, T.; Liston, E.; McFadyen, A.; Morgenstern, D. A.; Kalish, B. T.; Axford, M. M.; Deshwar, A. R.; Ivakine, Z.; Dowling, J. J.; Costain, G.
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PurposeTo describe the development of - and outcomes from - an institution-level initiative supporting access to innovative genetic medicines information and opportunities. MethodsWe developed and implemented a Genetic Medicines Patient Assessment Pathway for rare genetic conditions at a large public hospital, with multidisciplinary teams collaborating to evaluate a patients molecular and clinical amenability to experimental and/or to-be-developed genetic medicines (primarily nucleic acid therapeutics). A Genetic Medicines Consult Clinic operating in parallel offered no-cost specialized consultations and counseling to families regarding genetic medicines inquiries and Pathway outcomes. We retrospectively reviewed submissions, decisions, and outcomes over a >2-year period. ResultsA total of 63 submissions were reviewed in the Patient Assessment Pathway. Most submissions were classified as eligible or potentially eligible for at least one genetic medicines approach (42/63; 67%). Recommendations generated 87 discrete actions, such as outreach to potential collaborators (n = 28), offering participation in existing research studies (n = 23), or referral to the Consult Clinic (n = 19). Two patients have been approved for therapeutic program initiation or clinical trial enrolment. ConclusionFindings to date support feasibility and high uptake of a structured, multidisciplinary, medical genetics-led model for assessing patient-level opportunities for genetic medicines.
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