Genomics Tumour Advisory Board – our experience to date Provided by Catherine Carpenter-Clawson, Programme Manager, WE GMC

Background - 1 WE GMC phase 2 GMC have been actively consenting patients across our region since June 2016 4 organisations 10 tumour types 17 pathways with clinical leads & support ~600 patients consented by project close

Background - 2 July 2017 ‘core’ group met and developed Terms of Reference Standard Operating Procedures Suggested membership & ongoing queries WE GMC have received 16 results to date 3 organisations 3 tumour types 6 pathways with clinical leads Held ‘three’ monthly Genomics Tumour Advisory Boards ‘piloting the processes’

Our initial planning and processes….

Case Study: Ovarian Cancer Patient BRCA1:c.1146del p.(Asn383Metfs*11) identified Somatic (5% AF) Consistent with loss of heterozygosity (LOH) Classified as a Tier IA Variant of clinical significance associated with an approved therapy Confers sensitivity to Olaparib & approved by NICE IF: Patient has responded to platinum based chemotherapy Has had 3 or more courses of platinum based chemotherapy Eligibility for phase 3 and 4 trials in UK (Olaparib & Rucaparib) Reviewed at GTAB April ‘18 Patient has responded to platinum based chemotherapy ✓ Has had 3 or more courses of platinum based chemotherapy ❌ Has had 2 courses, following GTAB commenced 3rd Clinical Trials not suitable

Summary of Key Immediate Challenges Administration: Who, how and where are they sat, funded? Clinical resource & attendance: Who needs to attend and how are they funded to fit this into job plans? How do we get clinical engagement across the region? Process & governance: Are we discussing the right patients? How/where is the discussion recorded? Reporting and letter templates Logistics: How do you split the GTAB? By organisation? By tumour type? What does the future look like? Volume of patients Triaging patients Education, training & workforce development: How, who?  Informatics  

Addressing Immediate Challenges Request core administrator as part of return of results minimum funding requirements Discussions outlined individuals required to facilitate a Genomics Tumour Advisory Board: Clinical Chair of GTAB Genetics Consultant for Advisory Board Oncology Lead for GTAB Molecular Pathology Lead for GTAB  Clinical Scientist Provider specific clinical leads to co-ordinate local feedback How much time do they require? How do we resource this?

Addressing Immediate Challenges Process & governance: Highlighted today and continue to adapt and refine Reporting & letter templates: Workshop held in April and patients fed back on ‘no actionable findings letter’ – new version produced with patient contributors leading this. Logistics: Identifying local Trust leads to feed into a central meeting 6. & 7. Education & Informatics: ongoing challenges