Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug;37(Suppl 4):S22-S27.
doi: 10.12788/fp.0037.

VA National Precision Oncology Program

Michael J Kelley  1
Affiliations

VA National Precision Oncology Program

Michael J Kelley. Fed Pract. 2020 Aug.

Abstract

Background: The US Department of Veterans Affairs (VA) is the largest integrated health care system in the US. The VA sees about 50,000 new cancer diagnoses each year and provides care for more than 400,000 veterans with cancer. The heterogeneity of molecular testing practice patterns and methods of testing at VA health care facilities and the increasing number and complexity of molecular tests led to the development of national program for precision oncology.

Observations: The National Precision Oncology Program (NPOP) provides tumor sequencing and consultative services for the treatment of veterans with cancer. NPOP is used by nearly all VA oncology practices and has now sequenced > 13,000 samples. The initial focus was on advanced-stage nonsquamous non-small cell lung cancer, which has one of the highest number of mutated genes that result in sensitivity to antineoplastic drugs. Recently, testing was expanded to include metastatic prostate cancer and hematologic malignancies with prior approval. The program also offers cell-free DNA (liquid biopsy) and PD-L1 immunohistochemistry analyses.

Conclusions: The VA NPOP is one of the largest clinical DNA sequencing programs in the US with integrated consultation services and health informatics resources to facilitate patient care, clinical trials, and health outcomes research. The clinical services of NPOP provide cutting-edge oncology services to veterans throughout VA without exacerbating disparities and will be a national resource for research.

PubMed Disclaimer

Conflict of interest statement

Author disclosures The author reports no actual or potential conflicts of interest with regard to this article.

Figures

FIGURE 1
FIGURE 1
Chest Computed Tomography Showing Tumor Response to Crizotinib Between 2 (A) and 7 (B) Months After Diagnosis
FIGURE 2
FIGURE 2
Transition From Traditional Oncology to Precision Oncology
FIGURE 3
FIGURE 3
NPOP-Related Data Flowchart Abbreviations: NGS, next-generation sequencing; NPOP, National Precision Oncology Program; VCF, variant call format.
See this image and copyright information in PMC

References

    1. Lima ZS, Ghadamzadeh M, Arashloo FT, Amjad G, Ebadi MR, Younesi L. Recent advances of therapeutic targets based on the molecular signature in breast cancer: genetic mutations and implications for current treatment paradigms. J Hematol Oncol. 2019;12(1):38. doi: 10.1186/s13045-019-0725-6. Published 2019 Apr 11. - DOI - PMC - PubMed
    1. Fessler J, Matson V, Gajewski TF. Exploring the emerging role of the microbiome in cancer immunotherapy. J Immunother Cancer. 2019;7(1):108. doi: 10.1186/s40425-019-0574-4. Published 2019 Apr 17. - DOI - PMC - PubMed
    1. Kiang DT, Kennedy BJ. Tamoxifen (antiestrogen) therapy in advanced breast cancer. Ann Intern Med. 1977;87(6):687–690. doi: 10.7326/0003-4819-87-6-687.. - DOI - PubMed
    1. Paez JG, Jänne PA, Lee JC, et al. EGFR mutations in lung cancer: correlation with clinical response to gefitinib therapy. Science. 2004;304(5676):1497–1500. doi: 10.1126/science.1099314. - DOI - PubMed
    1. Poonnen P, Duffy J, Hintze BJ, et al. Genomic analysis of metastatic solid tumors in veterans: findings from the VHA National Precision Oncology Program. J Clin Oncol. 2019;37(suppl 15):3074. doi: 10.1200/JCO.2019.37.15_suppl.3074. - DOI - PMC - PubMed