Abstract SS01-01: Using genomic technologies to improve cancer risk assessment

Abstract

Abstract The heritable fraction of human cancers, estimated from genetic and epidemiologic approaches, is 21–42%. Heritable cancers include common adult onset malignancies (e.g. prostate, colon, breast cancers) as well as rarer cancers. During past decades, genetic approaches (e.g. linkage analysis and positional cloning) identified rare genetic mutations associated with markedly elevated cancer risk, with subsequent translation of these findings into effective preventive interventions. Recently genomic approaches (e.g. genome wide association studies [GWAS] exploiting linkage disequilibrium between single nucleotide polymorphisms in the human genome) have identified common variants of lower disease risk, as well as common variants which modify the risk of high-penetrance rare alleles. Ongoing studies are utilizing next-generation massively parallel sequencing (NGS) of whole exomes and genomes to identify the “missing heritability” of human cancer. The status GWAS and NGS approaches to cancer risk assessment will be reviewed. The large sample sizes required for GWAS will be emphasized; a case example of our recent consortium effort to identify genomic modifiers of BRCA2 penetrance will be cited. While the methods of identification of genomic variants are distinct, the principles of biomarker identification and clinical translation to preventive oncology are shared. These similarities include: the use of clinically validated variants that may not be functionally characterized; the segregation of these variants in non-Mendelian as well as Mendelian patterns; the role of gene–environment interactions; the dependence on evidence for clinical utility; the critical translational role of behavioral science; and common ethical considerations. It will be emphasized that during the current period of transition from investigation to practice, consumers must also be protected from harms of premature translation of research findings, while encouraging the innovative and cost-effective application of genomic discoveries that improve personalized oncologic care. Citation Information: Cancer Prev Res 2011;4(10 Suppl):SS01-01.