In Canada, the Access to Cancer Testing and Treatment program provides high quality cancer genomic testing to patients with metastatic or recurrent lung, breast, or colorectal cancer. Initially launched in 2019, Canexia Health has expanded geographic access to this testing program, currently offered at no cost to patients, which can help oncologists direct therapy selection and clinical trial options.
- What is Genomic Testing?
- Cancer is a disease in which the cells grow and divide out of control. Within each cell are many genes (the genome, made up of DNA), which control growth and division. Mutations (alterations or changes) in genes can affect how the cells grow and develop. Mutations in some of these genes can lead to cancer. There are many treatment options available for cancer patients, however, individual cancers that contain specific mutations may respond differently to the same therapy. The goal of genomic testing is to provide more information about specific gene mutations that may be present in your tumour so that your oncologist can recommend the most appropriate treatments.
Your oncologist can discuss and determine if genomic testing is right for you.
- What is the Follow It test?
- Circulating tumour DNA (ctDNA) are small pieces of DNA that come from tumour cells which can be found in your blood. As the tumour grows, its cells die and are replaced by new cancer cells. The dying tumour cells are broken down and their contents, including DNA, are discharged into the circulating bloodstream.
Follow It is a less invasive, blood-based ctDNA assay that tests for 146 of the most common mutations found in many adult solid tumours. Follow It requires a simple blood draw, similar to routine blood tests. It can be taken at an Ichor Blood Services location in Alberta, LifeLabs location in BC, Ontario, or Saskatchewan, or a Genolife location in Quebec. Patients in Newfoundland, New Brunswick, and Nova Scotia should speak directly to their oncologists. Blood samples are then sent directly to the Canexia Health laboratory in Vancouver, BC.
Once your blood sample arrives in our laboratory, we isolate the plasma portion of blood, which contains the ctDNA fragments. Then using Follow It we can determine the ctDNA mutations using our next-generation sequencing (NGS) technology without the need for an invasive tumour biopsy.
This is important because in patients with metastatic cancer, performing a tumour biopsy may be too difficult and invasive. Based on the presence of a specific ctDNA mutation detected in your blood sample, your oncologist may be able to select a targeted cancer treatment.
- Who is eligible for Follow It testing?
- Patients with recurrent or metastatic lung, breast, or colorectal cancers may benefit from testing with Follow It. At this time, we do not test hematological blood-based cancers such as lymphomas or leukemias.
Please talk to your oncologist to determine if Follow It is appropriate for you.
- How does this type of testing help treatment decisions?
- Follow It results may provide you and your oncologist with a better understanding of the gene mutations found in your tumour, thus allowing for the selection of targeted treatment options. This treatment may include a specific drug, standard treatment or an experimental drug where participation in a clinical trial may be suggested. Your oncologist will determine the most appropriate course of action regarding your therapy once the Follow It results are available.
- How can I get tested?
- Please consult your oncologist to determine whether you would benefit from Follow It. If deemed clinically beneficial, your oncologist can arrange for testing. Canexia Health does not play a role in selecting patients for the testing and does not offer testing to patients directly.
If you are eligible for Follow It, your oncologist will need to fill out the appropriate Test Requisition Form (TRF). If you reside in BC, Ontario, or Saskatchewan, take the Lifelabs TRF to your oncologist to fill out. You will then take the TRF to your nearest LifeLabs location to schedule blood collection.
If you reside in Quebec, take the Genolife TRF to your oncologist to fill out and send to Genolife. You will be contacted later to organize blood collection.
If you reside in Alberta, take the Ichor Blood Services TRF to your oncologist to fill out. You will then take the TRF to your nearest Ichor Blood Services location for blood collection. Please refer to the instructions in the TRF.
If you reside in Newfoundland, New Brunswick, or Nova Scotia, speak directly to your oncologist to find out more information about the test and where to get tested.
Once your blood is drawn, your samples will immediately be sent to the Canexia Health laboratory in Vancouver, BC.
- How do I let my oncologist know about this test?
- Please discuss the test with your oncologist as they are the best person to determine the benefits of this testing for you. Your oncologist can contact us to receive more information about Follow It if it is deemed clinically beneficial for you. Canexia Health does not play a role in selecting patients for testing.
Your oncologist can contact Canexia Health at firstname.lastname@example.org .
- Can my general practitioner refer me for your test?
- No. An oncologist must refer you for this test.
- Will this test determine my or my family’s susceptibility to cancer?
- No, Follow It is for patients who already have cancer. It is designed to provide more information about your tumour so that your oncologist can select the most appropriate therapy for you.Some types of cancers, called hereditary cancer, can result from genetic changes being passed down from your parents that may increase the chances of developing certain types of cancer in your lifetime. Canexia Health does not specifically test for these types of mutations.
- How much does the test cost?
- Through the Access to Cancer Testing and Treatment program, Follow It is funded for 2,000 Canadians with metastatic breast cancer, lung cancer, and colorectal cancer and is currently offered at no cost to the patient.
- Where is my sample sent?
- Your blood sample will be immediately sent for testing in Canexia’s clinically accredited laboratory in Vancouver, British Columbia, Canada.
- How long does it take to receive results?
- A detailed clinical report will be sent to your oncologist within 10 business days of your sample being received by Canexia Health laboratory.
- How do you ensure my privacy and confidentiality?
- Canexia Health is governed by the Personal Health Information Protection Act, 2004 (PHIPA) in the province of Ontario, the Personal Information Protection Act (PIPA) in the province of British Columbia and the federal Personal Information Protection and Electronic Documents Act (PIPEDA). We are also compliant with the Health Insurance Portability and Accountability Act – USA (HIPAA).
Canexia Health takes appropriate measures to protect personal health information in its possession from loss, misuse and unauthorized access, disclosure, alteration and destruction. We have implemented advanced physical, administrative and technical safeguards to protect the confidentiality, integrity and availability of personal data residing on, processed by or transmitted by our servers.
- Can a child be tested?
- No, Follow It is not designed to test mutations that are found in paediatric (childhood) cancers.