NYU Langone launches high-risk cancer program

Photo of Ophira Ginsberg
Ophira Ginsburg

NYU Langone’s Perlmutter Cancer Center launched a new program designed to identify, study and care for high-risk patients who have hereditary syndromes that increase cancer risk.

Ophira Ginsburg, MD, medical oncologist at NYU Langone Medical Center, has been named program director. Her research interests include cancer disparities in North America, as well as in low- and middle-income countries.

Ginsburg’s efforts to improve cancer outcomes — particularly for women — in underserved populations began in 2004. She served as medical officer for cancer control at WHO from 2015 to 2016.

“My greatest passions are being of service to others, innovating systems of care and pursuing new knowledge in the interests of reducing cancer risk and cancer disparities — both locally and globally,” Ginsburg told HemOnc Today. “What excites me the most about joining the Perlmutter Cancer Center at NYU Langone is the opportunity to take an already great service and lead its transformation into a comprehensive, state-of-the-art, high-risk cancer genetics program.”

HemOnc Today spoke with Ginsburg about how the program came about, whom it will serve and its potential impact.

Question: How did this program come about?

Answer: For a number of years, NYU Langone’s Perlmutter Cancer Center has had a high-quality service for patients with hereditary cancer. We have four genetic counselors and a high-risk clinician who have been working to ensure we have equitable access for high-quality hereditary cancer counseling and clinical management. Until now, there has not been a comprehensive program with someone leading the entire initiative to ensure that all aspects are covered and that we are providing state-of-the-art cancer care.

Q: What type of care will the program provide?

A: We have four program objectives. The first is to identify, inform, educate and counsel individuals and families with suspected or confirmed hereditary cancer about the nature of hereditary cancer. We will provide individualized cancer risk assessments and advice on patient-tailored, evidence-based cancer risk–reduction options. We also want to provide navigation so people with high-risk cancers can be ushered easily through what can be a complicated health care system; this will ensure timely access to the specialty services they require to make informed decisions regarding enhanced screening. These include breast MRI for women with breast cancer, or prophylactic or risk-reducing surgery for people who carry a BRCA1 or BRCA2 pathogenic variant gene mutation to prevent breast or ovarian cancer. We also will provide opportunities for cancer genetics research, including clinical and translational research, as well as health services and other types of research that really can only happen when you have a comprehensive, efficient, data-driven program. Lastly, we will provide education for public and primary providers from all specialties, so they are prepared and up to date about all things hereditary cancer.

Q: Who will the program serve?

A: Our program will serve women with a family history of breast or ovarian cancer, as well as women and men who may be at increased risk for breast cancer or other malignancies due to a hereditary susceptibility. We will see families with suspected Lynch syndrome, polyposis syndromes and Cowden syndrome, among others. In the era of multigene panel testing, we expect to see more families with multiple different cancers that do not fit the traditional known syndromes but who demonstrate inherited susceptibility, such as a pathogenic variant in an actionable gene, that warrants counseling and opportunities for risk-reducing interventions. Additionally, we will reach out to primary and specialty care practitioners to increase access to cancer genetics services for men with a strong family history of prostate cancer, who should be offered counseling and testing for BRCA2. Men with a BRCA2 pathogenic variant are particularly at risk for aggressive prostate cancer, so screening and appropriate treatment can save lives. Diane M. Simeone, MD, has tremendous expertise in pancreatic genetics. She will establish a research program for families specifically at high risk for pancreatic cancer.

We have experts in pediatrics and medical genetics who are our focal points for hereditary cancers that affect children, such as Li-Fraumeni syndrome, associated with the TP53 germline gene mutation. Finally, we hope to improve our provider and public education strategies so more people who are truly at high risk for cancer but who do not have a personal cancer history are offered the opportunity to access our program. Although more people in the United States are undergoing genetic testing, a greater proportion of these individuals are not actually at high risk. At the same time, we are not seeing the levels of so-called ‘cascade testing’ that we would expect in most high-risk programs, nor do we see enough unaffected high-risk individuals coming forward for counseling and testing. This is particularly the case in otherwise underserved communities, including minority groups. A core value of our program is to improve equitable access to cancer genetics services.

Q: How did you become program director?

A : I started as a genetic counselor in the early 1990s at McGill University, where I worked with Steven Narod, MD, FRCPC, FRSC, one of the leading scientists in hereditary breast cancer. After this, I decided to go to medical school, became a medical oncologist, and focused on hereditary cancer. I also developed a research interest in cancer disparities and global oncology. For the past 10 years, I led a cancer genetics program in Canada. I left Canada in 2015 for a yearlong post as medical officer at WHO in Geneva. Then I found a terrific opportunity and fit here at NYU.

Q: What is your ultimate hope for the program?

A: I hope the program provides state-of-the-art comprehensive cancer genetics services to all NYU patients and advances the latest in cutting-edge translational research in cancer genetics.

Q: Are there plans for future initiatives within the program?

A: At the moment, the major challenge is getting the entire program under one umbrella. Another area of focus is having one universal process for sending patients for research, which will be aligned with our biobank at Perlmutter Cancer Center. This is an exciting opportunity to ensure our high-risk patients are engaged as much as they wish to be in discovery research. – by Jennifer Southall

For more information:

Ophira Ginsburg, MD, can be reached at NYU Langone Perlmutter Cancer Center, 160 E. 34th St. #4, New York, NY 10016; email: ophira.ginsburg@nyumc.org.

Disclosure: Ginsburg reports no relevant financial disclosures.

Photo of Ophira Ginsberg
Ophira Ginsburg

NYU Langone’s Perlmutter Cancer Center launched a new program designed to identify, study and care for high-risk patients who have hereditary syndromes that increase cancer risk.

Ophira Ginsburg, MD, medical oncologist at NYU Langone Medical Center, has been named program director. Her research interests include cancer disparities in North America, as well as in low- and middle-income countries.

Ginsburg’s efforts to improve cancer outcomes — particularly for women — in underserved populations began in 2004. She served as medical officer for cancer control at WHO from 2015 to 2016.

“My greatest passions are being of service to others, innovating systems of care and pursuing new knowledge in the interests of reducing cancer risk and cancer disparities — both locally and globally,” Ginsburg told HemOnc Today. “What excites me the most about joining the Perlmutter Cancer Center at NYU Langone is the opportunity to take an already great service and lead its transformation into a comprehensive, state-of-the-art, high-risk cancer genetics program.”

HemOnc Today spoke with Ginsburg about how the program came about, whom it will serve and its potential impact.

Question: How did this program come about?

Answer: For a number of years, NYU Langone’s Perlmutter Cancer Center has had a high-quality service for patients with hereditary cancer. We have four genetic counselors and a high-risk clinician who have been working to ensure we have equitable access for high-quality hereditary cancer counseling and clinical management. Until now, there has not been a comprehensive program with someone leading the entire initiative to ensure that all aspects are covered and that we are providing state-of-the-art cancer care.

Q: What type of care will the program provide?

A: We have four program objectives. The first is to identify, inform, educate and counsel individuals and families with suspected or confirmed hereditary cancer about the nature of hereditary cancer. We will provide individualized cancer risk assessments and advice on patient-tailored, evidence-based cancer risk–reduction options. We also want to provide navigation so people with high-risk cancers can be ushered easily through what can be a complicated health care system; this will ensure timely access to the specialty services they require to make informed decisions regarding enhanced screening. These include breast MRI for women with breast cancer, or prophylactic or risk-reducing surgery for people who carry a BRCA1 or BRCA2 pathogenic variant gene mutation to prevent breast or ovarian cancer. We also will provide opportunities for cancer genetics research, including clinical and translational research, as well as health services and other types of research that really can only happen when you have a comprehensive, efficient, data-driven program. Lastly, we will provide education for public and primary providers from all specialties, so they are prepared and up to date about all things hereditary cancer.

PAGE BREAK

Q: Who will the program serve?

A: Our program will serve women with a family history of breast or ovarian cancer, as well as women and men who may be at increased risk for breast cancer or other malignancies due to a hereditary susceptibility. We will see families with suspected Lynch syndrome, polyposis syndromes and Cowden syndrome, among others. In the era of multigene panel testing, we expect to see more families with multiple different cancers that do not fit the traditional known syndromes but who demonstrate inherited susceptibility, such as a pathogenic variant in an actionable gene, that warrants counseling and opportunities for risk-reducing interventions. Additionally, we will reach out to primary and specialty care practitioners to increase access to cancer genetics services for men with a strong family history of prostate cancer, who should be offered counseling and testing for BRCA2. Men with a BRCA2 pathogenic variant are particularly at risk for aggressive prostate cancer, so screening and appropriate treatment can save lives. Diane M. Simeone, MD, has tremendous expertise in pancreatic genetics. She will establish a research program for families specifically at high risk for pancreatic cancer.

We have experts in pediatrics and medical genetics who are our focal points for hereditary cancers that affect children, such as Li-Fraumeni syndrome, associated with the TP53 germline gene mutation. Finally, we hope to improve our provider and public education strategies so more people who are truly at high risk for cancer but who do not have a personal cancer history are offered the opportunity to access our program. Although more people in the United States are undergoing genetic testing, a greater proportion of these individuals are not actually at high risk. At the same time, we are not seeing the levels of so-called ‘cascade testing’ that we would expect in most high-risk programs, nor do we see enough unaffected high-risk individuals coming forward for counseling and testing. This is particularly the case in otherwise underserved communities, including minority groups. A core value of our program is to improve equitable access to cancer genetics services.

Q: How did you become program director?

A : I started as a genetic counselor in the early 1990s at McGill University, where I worked with Steven Narod, MD, FRCPC, FRSC, one of the leading scientists in hereditary breast cancer. After this, I decided to go to medical school, became a medical oncologist, and focused on hereditary cancer. I also developed a research interest in cancer disparities and global oncology. For the past 10 years, I led a cancer genetics program in Canada. I left Canada in 2015 for a yearlong post as medical officer at WHO in Geneva. Then I found a terrific opportunity and fit here at NYU.

PAGE BREAK

Q: What is your ultimate hope for the program?

A: I hope the program provides state-of-the-art comprehensive cancer genetics services to all NYU patients and advances the latest in cutting-edge translational research in cancer genetics.

Q: Are there plans for future initiatives within the program?

A: At the moment, the major challenge is getting the entire program under one umbrella. Another area of focus is having one universal process for sending patients for research, which will be aligned with our biobank at Perlmutter Cancer Center. This is an exciting opportunity to ensure our high-risk patients are engaged as much as they wish to be in discovery research. – by Jennifer Southall

For more information:

Ophira Ginsburg, MD, can be reached at NYU Langone Perlmutter Cancer Center, 160 E. 34th St. #4, New York, NY 10016; email: ophira.ginsburg@nyumc.org.

Disclosure: Ginsburg reports no relevant financial disclosures.