The Pancreatic Cancer Action Network’s Know Your Tumor precision medicine service, provided in partnership with Perthera, is an IRB-approved protocol using CLIA-certified laboratories that provides you with a molecular profiling report of your patient’s tumor. The report includes treatment options, determined after an expert panel interprets the findings, providing valuable insight to support your treatment decisions.
Dr. Vaibhav Sahai and his colleagues at University of Michigan have received close to 30 Know Your Tumor reports. Dr. Sahai has discovered many potentially actionable mutations from the reports, giving their patients access to more treatment options, through consideration of off-label treatments and genomically driven clinical trials.
About Dr. Sahai
Dr. Vaibhav Sahai is a medical oncologist at University of Michigan and specializes in treatment of pancreaticobiliary cancers, with approximately 80% of his practice comprised of patients with pancreatic cancer.
His research interests include clinical and experimental therapeutics in pancreaticobiliary cancers via a molecular-based approach in the laboratory with an overarching goal to reduce the morbidity and mortality in these cancers. Dr. Sahai is a member of the Pancreatic Cancer Action Network’s Precision PromiseSM Committee.
Why Dr. Sahai Turned to Know Your Tumor
“The current chemotherapy regimens are not of much benefit in improving prognosis for our patients with pancreatic cancer,” Dr. Sahai shared. “We strive to get them enrolled in clinical trials to expand their therapeutic options. Know Your Tumor allows us to identify mutations in their genomic profile and direct them to specific clinical trials with targeted drugs that would potentially benefit them.”
Through Know Your Tumor, Dr. Sahai has diagnosed several of his patients with mutations in BRCA1, BRCA2, ATM or PALB2, along with other rarer mutations, which have enabled them to enroll in biomarker driven clinical trials. “Some of these patients with metastatic cancer are alive more than three years out on off-label therapies due to the mutations detected via Know Your Tumor.”
Dr. Sahai has received off-label treatment recommendations for many of his patients through Know Your Tumor. It can be a challenge to have these treatments covered by insurance, but Dr. Sahai and his team have had a high success rate when petitioning insurance and pharmaceutical companies for off-label therapeutics for their patients with pancreatic adenocarcinoma. “We generate comprehensive letters citing both pre-clinical and clinical data, if available, to support and provide rationale to try the off-label medications.” Perthera also offers support to patients and physicians with this process as well as other insurance issues that may arise, such as patients not being able to afford the co-pay for off-label medications.
Lessons Learned from Dr. Sahai
As a physician who has referred around 25 patients to Know Your Tumor, Dr. Sahai understands what is needed to help usher patients successfully through the service.
Working with patients
- Discuss Know Your Tumor with pancreatic cancer patients if they have an accessible tumor which can be biopsied, or existing tissue from prior surgery or core biopsy
- Educate the patients and provide detailed written information, including:
- The rationale for undergoing molecular profiling and its potential for increasing treatment options
- The Know Your Tumor process and next steps, along with contact information for Perthera and PanCAN
- The reason for starting this process now and using the report for next-line treatment
- Frequently asked questions about Know Your Tumor
- The potential financial implications of a repeat biopsy and molecular testing. The cost of medical procedures, including biopsies, and molecular testing is billed to the patient’s insurance company. PanCAN covers the cost of Perthera’s services, including the report generated.
You and your team
- Understand your role in the Know Your Tumor process: “I educate patients, help coordinate their biopsy, and discuss the results and their implications, including clinical trials available across the U.S.”
- Get other team members on board with Know Your Tumor and the process for more fluid and efficient execution: “I have had personal discussions regarding this process with my physician assistant, nurse, colleagues who also see patients with pancreatic cancer (and provide them the written information to disperse to patients) as well as my colleagues in interventional radiology and pathology (which helps expedite the process and smooth out the creases).”
- Report patient outcomes to Perthera when they follow up. This will help us learn even more about the disease and how well the treatments prescribed work to treat it.
Using the report
- Understand that the report process will take approximately 25-45 days from receipt of tissue. Additionally, if a tissue sample is not already available, you should factor in the time needed to obtain a tissue sample when considering the amount of time that will lapse before you receive a patient’s report. Begin the process early and use the report to help inform next-line treatment.
- Use the Pancreatic Cancer Action Network and Perthera as resources.
Join Dr. Sahai by referring your eligible pancreatic cancer patients to Know Your Tumor. For more information and support, contact us at 877-272-6226 or complete our contact form. Case Managers are available to answer your questions M – F, 7 a.m. – 5 p.m. PT.
We’ve compiled some resources to help you with this process:
- Patient Packet to help your patients understand molecular profiling, Know Your Tumor and the process, including frequently asked questions
- Healthcare Professional Packet to help your colleagues understand Know Your Tumor
- Healthcare Professional Frequently Asked Questions, including eligibility criteria
- Order Form to refer a patient to Know Your Tumor; Perthera and the Pancreatic Cancer Action Network will follow up with the patient for next steps