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

2. 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

3. 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’

4. Our initial planning and processes….

6. 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

7. 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  

8. 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?

9. 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