JUN 21, 2018 12:00 PM PDT
Whole Genome Sequencing As A Valuable Clinical Tool For the Management of Cancer Patients
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  • Professor and Consultant at Mayo Clinic
      David I Smith received his Ph.D. in Biochemistry from the University of Wisconsin in Madison in 1978 studying antibiotic resistance in bacteria. After doing post-doctoral work first at the Albert Einstein College of Medicine and then at the University of California, Irvine, he got his first faculty position at Wayne State University in 1985. In 1996 he joined the Mayo Clinic as a full Professor in the Department of Laboratory Medicine and Pathology. His laboratory studies the common fragile sites which are regions of profound genomic instability that are found in all individuals. His laboratory also studies the various ways that human
      papillomavirus is involved in the generation of different cancers. Dr. Smith is also the Chairman of the Technology Assessment Group for the Mayo Clinic Center for Individualized Medicine. The role of this group is to evaluate new technologies that could have a profound impact on basic research and its' clinical translation. The most exciting technology that has the greatest potential to change both research and clinical practice is next generation sequencing and Dr. Smith and his group have been using this technology to answer scientific questions. The advances in next generation sequencing over the past 10 years have been nothing
      short of incredible and it is now possible to generate terrabases of DNA sequence in a single run of a next generation sequencer. This technology can be utilized in a number of ways from characterizing just a few genes all the way to whole genome sequencing.


    Advances in DNA sequencing, based upon massively parallel sequencing, has resulted in dramatic advances in DNA sequence output in the past few years. It is now possible to generate terrabases of accurate DNA sequence with a single run on several DNA sequencing platforms. This has then made it possible to characterize alterations that occur during cancer development. Genomic alterations can be characterized by targeted sequencing of genes that are frequently altered during cancer development, by sequencing of the entire exome, transcriptome sequencing, and even by whole genome sequencing. Each of these has their own inherent strengths and weaknesses. I will describe why I believe that the best strategy moving forward for the management of cancer patients is whole genome sequencing (WGS). This can currently be done reliably and inexpensively on two completing platforms. The first is the Illumina sequencing platform and the second is from BGI. WGS is a comprehensive technology that can detect all the alterations in a cancer genome and I will describe how and why this may prove to be the best approach for the management of cancer patients.

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