Returning individual research results for genome sequences of pancreatic cancer
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  • 作者:Amber L Johns (1)
    David K Miller (6)
    Skye H Simpson (1)
    Anthony J Gill (4)
    Karin S Kassahn (6) (8)
    Jeremy L Humphris (1)
    Jaswinder S Samra (5)
    Katherine Tucker (7)
    Lesley Andrews (7)
    David K Chang (1) (10) (9)
    Nicola Waddell (6)
    Marina Pajic (1)
    John V Pearson (6)
    Sean M Grimmond (6)
    Andrew V Biankin (1) (10) (11) (12) (13) (14) (9)
    Nikolajs Zeps (2) (3)
    Australian Pancreatic Cancer Genome Initiative

    1. Cancer Research Program
    ; Garvan Institute of Medical Research ; the Kinghorn Cancer Centre ; Sydney ; NSW ; 2010 ; Australia
    6. Queensland Centre for Medical Genomics
    ; Institute for Molecular Biosciences ; University of Queensland ; St Lucia ; QLD ; 4072 ; Australia
    4. Department of Anatomical Pathology
    ; Royal North Shore Hospital ; Sydney Australia and University of Sydney ; Sydney ; NSW ; 2065 ; Australia
    8. Genetic and Molecular Pathology
    ; SA Pathology ; Women鈥檚 and Children鈥檚 Hospital ; North Adelaide ; SA ; 5006 ; Australia
    5. Department of Surgery
    ; Royal North Shore Hospital ; Sydney ; NSW ; 2065 ; Australia
    7. Hereditary Cancer Clinic
    ; Prince of Wales Hospital ; Randwick ; Sydney ; NSW ; 2031 ; Australia
    10. West of Scotland Pancreatic Unit
    ; Glasgow Royal Infirmary ; Glasgow ; Scotland ; UK
    9. Wolfson Wohl Cancer Research Centre
    ; Institute of Cancer Sciences ; University of Glasgow ; Glasgow ; Scotland ; UK
    11. Department of Surgery
    ; Bankstown Hospital ; Eldridge Road ; Bankstown ; Sydney ; NSW ; 2200 ; Australia
    12. South Western Sydney Clinical School
    ; Faculty of Medicine ; University of New South Wales ; Sydney ; NSW ; 2170 ; Australia
    13. Wolfson Wohl Cancer Research Centre
    ; Institute of Cancer Sciences ; University of Glasgow ; Garscube Estate ; Switchback Road ; Bearsden ; Glasgow ; Scotland ; G61 1BD ; UK
    14. Garvan Institute of Medical Research
    ; 370 Victoria St ; Darlinghurst ; NSW ; 2010 ; Australia
    2. St John of God Subiaco
    ; Perth ; WA ; 6008 ; Australia
    3. School of Surgery
    ; The University of Western Australia ; Perth ; WA ; 6009 ; Australia
  • 刊名:Genome Medicine
  • 出版年:2014
  • 出版时间:May 2014
  • 年:2014
  • 卷:6
  • 期:5
  • 全文大小:228 KB
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  • 刊物主题:Human Genetics; Proteomics; Bioinformatics; Internal Medicine;
  • 出版者:BioMed Central
  • ISSN:1756-994X
文摘
Background Disclosure of individual results to participants in genomic research is a complex and contentious issue. There are many existing commentaries and opinion pieces on the topic, but little empirical data concerning actual cases describing how individual results have been returned. Thus, the real life risks and benefits of disclosing individual research results to participants are rarely if ever presented as part of this debate. Methods The Australian Pancreatic Cancer Genome Initiative (APGI) is an Australian contribution to the International Cancer Genome Consortium (ICGC), that involves prospective sequencing of tumor and normal genomes of study participants with pancreatic cancer in Australia. We present three examples that illustrate different facets of how research results may arise, and how they may be returned to individuals within an ethically defensible and clinically practical framework. This framework includes the necessary elements identified by others including consent, determination of the significance of results and which to return, delineation of the responsibility for communication and the clinical pathway for managing the consequences of returning results. Results Of 285 recruited patients, we returned results to a total of 25 with no adverse events to date. These included four that were classified as medically actionable, nine as clinically significant and eight that were returned at the request of the treating clinician. Case studies presented depict instances where research results impacted on cancer susceptibility, current treatment and diagnosis, and illustrate key practical challenges of developing an effective framework. Conclusions We suggest that return of individual results is both feasible and ethically defensible but only within the context of a robust framework that involves a close relationship between researchers and clinicians.

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