Blood cancers are among the most common and lethal cancers in Australia, with 6-7000 deaths per year and a peak in young patients. High risk blood cancers such as aggressive lymphoma or leukaemia usually respond to chemotherapy at initial diagnosis. However, relapsed or refractory disease is associated with chemotherapy resistance and this invariably leads to poor outcomes for patients with most studies showing survival of relapsed/ refractory AML/ ALL or DLBCL approximately 10-20% at 2 years.
Recent advances in analytical genomics have been able to identify driver lesions within the cancer cell DNA in many patients with high risk blood cancers, however there is no pathway to accessing novel therapeutics that may target these pathways. Testing of the DNA sequence of tumours is not universally available, is often associated with a significant out of pocket cost for the patient and may have a long turnaround, limiting the use of genetics to a select few patients.
We describe a pilot study to test the feasibility of rapid turnaround genetic testing, multidisciplinary tumour board reporting and genetically directed targeted therapy for patients with relapsed or refractory high-grade haematological malignancies.