Individualized Medicine Clinic
The Individualized Medicine Clinic (IM Clinic) offers genomic testing to patients in order to further personalize care. Health care providers use knowledge about a patient’s genome (or DNA) to diagnose, predict, treat and prevent disease – allowing medical care to be tailored to the patient’s genomic make-up.
Through the IM Clinic, our team of scientists and physicians integrates whole-genome and whole-exome sequencing into patient care, creating a model of precision medicine that helps us understand each patient and his or her disease at the most fundamental level.
Currently, the Individualized Medicine Clinic treats patients with advanced cancers and those with rare or undiagnosed diseases believed to have genetic causes (also known as "a diagnostic odyssey").
Patients are considered for the Individualized Medicine Clinic in Rochester, Minn., Jacksonville, Fla., and Scottsdale, Ariz., on a case-by-case basis.
Candidates for the Individualized Medicine Clinic include patients with:
- Advanced cancer. Cancer treatment typically focuses on patients whose cancer continues to progress after standard treatment options fail. Our team uses whole-genome or whole-exome sequencing of both normal DNA and tumor DNA to look for changes or alterations in the cancer that may be targeted by new therapies. Treatment is tailored to the individual patient's genome and the genetic alterations of the tumor.
Rare and undiagnosed diseases. Despite rapid advances in medical genetics and genetic testing, many diseases remain difficult or impossible to diagnose. Often, patients have had prior genetic testing that has yielded unclear or inconclusive results.
This is particularly true for many rare diseases, orphan diseases, diseases with early and childhood onset, and those syndromes with unknown causes. In some cases, it is possible that families carry a genetic variation so unique that it exists nowhere else in the world.
In these cases, our team of scientists and physicians uses whole-genome and whole-exome sequencing to look for genetic variations to help diagnose disease. It is possible that this results in identifying variants that are vulnerable to drugs and new therapies.
If you are a patient in one the above categories, the steps involved in an appointment with the Individualized Medicine Clinic may include:
- You or your physician requests an evaluation from the Individualized Medicine Clinic.
- An Individualized Medicine Consultant evaluates your request and advises on whether or not next-generation sequencing might be a benefit to the understanding and treatment of your disease.
- You meet with a genetic counselor trained to provide genomic education and decision-making support.
- Your DNA is obtained via blood draw, other tissue samples or both.
- Your exome is sequenced and bioinformatics analysis is performed, searching for the handful of variants within your DNA sequence that might be contributing to your condition.
- A multidisciplinary team of experts evaluates your results with a focus on understanding your disease and/or tailoring your treatment options.
- After the medical team has evaluated your sequencing results, a genetic counselor and/or physician meet with you to discuss the findings. Should the results reveal any information about treatment options, such as in the case of cancer, then your testing physician receives these results and can advise you on available treatment options.
Patients first meet with a disease specialist to discuss their unique case. Blood will be drawn — and in some cases, tissue samples obtained — to extract DNA for sequencing.
Genetic counselors help patients understand the sequencing process and possible implications of results, as well as work with them to determine how much genetic information they want to know before their DNA sequence is analyzed.
For instance, would patients want to know if they carry genetic variations with known relevance to other disorders? Some would like to know, while others choose to receive information pertaining only to their current medical condition. It's a personal decision that patients have the right to make for themselves.
After the medical team has evaluated the sequencing results, a genetic counselor and physician meet with the patient to discuss the findings and, when possible, make new treatment and lifestyle decisions.
Personalized Care Team
The hallmark of Mayo's Individualized Medicine Clinic is the multidisciplinary collaboration of our team of experts, which includes physicians, genomic scientists, genetic counselors, bioinformaticians, laboratory professionals and bioethics representatives.
The team analyzes each individual case, working together to understand the genome of each individual patient.
Team members include:
- Primary physician. To ensure you receive the best possible care, we invite and encourage your primary care provider to participate in all discussions about your case. This can be done by teleconference or video conference when appropriate.
- IM Clinic consultants and physician specialists. These doctors include specialists in medical genetics, general internal medicine, pediatrics, gastroenterology, cardiovascular diseases, pathology, hematology, oncology and other areas.
- Genetic counselors. These health professionals work with doctors and families to help patients understand the process and implications of genome sequencing. They also provide education and support for patients and assist with genome analysis.
- Laboratory professionals. These doctorate-level scientists include molecular pathologists and biologists, geneticists, biochemists, and others. They help the team understand how individual changes at the submicroscopic level affect a patient's condition.
- Bioinformaticians. This specialized team combines computer science with biology and genetics to filter and distill the trillions of pieces of information from your genome into a brief report that you and your provider can use.
- Bioethicist. A representative from bioethics works with the group from start to finish, helping to ensure that all ethical, legal and social implications are considered.