Genomics and Precision Oncology Learning Library

Genomics Learning Library

Discover what you can learn on our Precision Oncology online learning library. Explore resources compiled of both ONS and external content such as practice tools, courses, case studies, webinars, podcasts, websites, and more.

The ONS Genomics Advisory Board invites you to share your stories, ideas, or needs in relation to integrating genomics into cancer care.  Submit your questions, comments and thoughts for consideration by the Genomics Advisory Board.

Learn More About the ONS Genomics Advisory Board

The ONS Genomics Advisory Board was established in May 2019 to guide the development of genomic education and practice resources for oncology nurses. Cancer care is in the midst of a massive paradigm shift. The cancer care workforce, both current and future, is under-prepared for the rapid application of genomic discoveries and the changes needed in cancer care delivery. We want to assure that the current and next generation of oncology nurses know the science, can apply the latest evidence in practice, and translate this information to patients and families.

Advisory Board Members
 
Kathleen Calzone, PhD, RN, AGN-BC, FAAN
Patricia Friend PhD, APRN-CNS, AOCNS®, AGN-BC
Patricia A. Kelly, DNP, APRN, CNS, AGN-BC, AOCN®
Suzanne Mahon, RN, DNSc AOCN®, AGN-BC
Mary L. Schmitt, MS, APRN, FNP-BC, AOCNP®
Kerensa Marty, RN MSN/Ed OCN 

 
Subject Matter Expert Contributors

Julie Martin, DNP, AOCN®, FNP-BC
Jessica Pforr, MSN, NP-C, AOCNP®
Kathy Pratt, BSN, RN, OCN, CBCN, ONN-CG
Yvonne Ruddy-Stein APRN AGN-BC
Meaghan Ryan, MSN, FNP-BC
 

Clinical Practice Resources

Clinical practice resources support the integration of the latest evidence into practice and assist in the translation of this information to patients and families.

Is My Cancer Hereditary? Discussion Tool

Utilize this tool to discuss hereditary cancer risk with a patient. It provides a list of hereditary risk red flags and helps in educating the patient on why they may need to be referred to a genetics professional.
This resource was developed by ONS through a sponsorship from AstraZeneca.

When to Refer to a Genetics Professional Quick Guide

Refer to this infographic to recall the red flags of hereditary cancer risk and identify when a patient would be appropriate to refer to a genetics professional. Additional information gathering could lead to more individualized treatment options for the patient and cascade testing for family. 
This resource was developed by ONS through a sponsorship from AstraZeneca.

Biomarker Testing in Non-Small Cell Lung Cancer Discussion Tool

Explaining the complex biomarker testing process to your patients can be made simple by utilizing the Biomarker Testing in Non-Small Cell Lung Cancer Discussion Tool to guide this conversation with your patients. It provides patient friendly language to describe biomarker testing and the why, when, and how of the process. It gives the patient space to write notes and capture their cancer’s biomarkers.  Also, available for download is the facilitator guide which describes two models you may use when reviewing the discussion tool with a group of nurses.
This resource was developed by ONS through a sponsorship from Amgen.

 

ONS Learning Tools

Do You Know How to Talk to Your Patients About At-Home Genetic Testing?

Engage in the case of a young breast cancer patient of Ashkenazi Jewish descent that completed at-home genetic testing to inform her inherited risk for cancer. Find out what that test told her and the misconceptions many patients have about their at-home genetic testing results.
This resource was developed by ONS through a sponsorship from AstraZeneca.

Genetic Disorder Reference Sheets

These concise and comprehensive genetic disorder reference sheets include details about the disorder, cancer risk, recommendations for care, and nursing implications. CHEK2 and Lynch Syndrome are currently available and more to be released every other month.

ONS Genomic Testing in Cancer Care Webinar

Genomic technologies are rapidly being integrated into cancer care. Genetic/genomic tests are applied across the cancer care continuum for risk identification, risk reduction and cancer prevention, diagnosis and treatment. Oncology nurses must be knowledgeable about the different types of technologies/tests including when and how they are used so they can navigate patients and families through the maze of precision oncology.
Earn 1 NCPD ILNA categories: Scientific Basis, Professional, Disease-Related Biology, and Basic Concepts and Indications for Transplantation

ONS Courses

Learners will find genomics included in varying detail depending on the course they are completing. Some examples are Cancer Biology, ONS/ONCC Chemotherapy and Immunotherapy Certificate Course, Immunotherapy in Cancer Treatment, A Primer on the Role of the Immune System, and many more!

Navigating Genomics and Its Effect on Cancer Care

ONS member Celeste Adams, RN, BSN, MBA, nurse navigator at Intermountain Healthcare in Salt Lake City, UT, and member of the ONS Intermountain Chapter, and Kathleen Wiley, RN, MSN, AOCNS®, director of oncology nursing practice at ONS, discuss how nurse navigators can help patients and caregivers understand genomic advancements, how someone’s genes affect cancer prevention and treatment, and the impact that genomics testing can have on a patient’s quality of life.  (Podcast: 29 minutes)

Genomic "Glad You Asked" Video Series

In a recent survey, we asked ONS members what they wanted to know more about as it relates to genomics. In these short videos, members of our Genomics Advisory Board answer those questions and topics that were identified through that survey. 

Genomic "Glad You Asked" Video Series Introduction

What is the correct genomics terminology?

Can pathogenic variants skip a generation?

Where can I find more information about genomics?

Is a variant the same as a mutation?

What happens to my genetic information?

What are key indicators of hereditary risk for cancer?

How do you create a pedigree?

Is there a difference between clinical genetic testing and consumer-focused testing?

What is meant by wild-type?

What is the difference between germline and somatic variants?

What is the role of the KRAS biomarker in NSCLC?
This resource was developed by ONS through a sponsorship from Amgen.

How do I talk to patients about genomics?
This resource was developed by ONS through a sponsorship from AstraZeneca.

How are DNA testing technologies used in cancer care?
This resource was developed by ONS through a sponsorship from AstraZeneca.

What is the purpose of biomarker testing for somatic variants?
This resource was developed by ONS through a sponsorship from AstraZeneca.

What are biomarkers?
This resource was developed by ONS through a sponsorship from AstraZeneca.

ONS Articles

Clinical Journal of Oncology Nursing and Oncology Nursing Forum

ONS Voice Articles

ONS Voice has published over 75 articles on the topic of genomics in cancer care. Review the library of articles. Highlighted articles and information:

Voice Article

Key Content

What Is the Different Between Genetics and Genomics?

 

“Genetics versus genomics: Is there a difference? Does it even matter? There is, and it does. In our era of precision medicine, also referred to as individualized or genomic medicine, being able to differentiate the terms is a first step in establishing a foundational understanding of what they mean for cancer care from prevention to treatment.
According to the National Human Genome Research Institute (NHGRI), genetics is the study of individual genes, whereas genomics is the study of the entire genome, or all of an organism’s genes, interactions among genes, and the environment’s role in affecting them.”

Germline and Somatic Mutations: What Is the Difference?

 

“Somatic Mutations”
Somatic or acquired mutations are the most common cause of cancer. These mutations occur from damage to genes in an individual cell during a person’s life. Cancers that occur because of somatic mutations are referred to as sporadic cancers. Somatic mutations are not found in every cell in the body and they are not passed from parent to child. Some common carcinogens that cause these mutations include tobacco use, ultraviolet radiation, viruses, chemical exposures, and aging.

"Germline Mutations”
Germline mutations are far less common. A germline mutation occurs in a sperm cell or an egg cell and is passed directly from a parent to a child at the time of conception. As the embryo grows into a baby, the mutation from the initial sperm or egg cell is copied into every cell in the body. Because the mutation affects reproductive cells, it can pass from generation to generation.

How DNA Sequencing Technologies Are Used in Cancer Care, Now and in the Future

 

“What Is the Difference Between the Techniques?”
Think of DNA as letters of the alphabet. Letters are arranged to make words, sentences, chapters, and entire books. Genes are defined as DNA that is functionally active or that codes for a protein, but most elements of human DNA are considered non-coding. Non-coding DNA (not a gene) still has important regulatory functions and may affect the expression and regulation of nearby genes (coding DNA). The techniques differ based on how much DNA is sequenced.
 - The entire book: Sequences each of the approximately 3 billion base pairs, including all non-coding regions. This is known as whole genome sequencing (WGS).
 - A few sentences in each chapter: Only sequences the coding regions of a person’s genome (the exons). This is known as whole-exome sequencing (WES) and represents about 2% of a person’s total DNA.
 - A paragraph or even a single line of text: This is known as targeted DNA sequencing and is used for known pathogenic variants. Targeted sequencing can look for those variants in a single gene (e.g., BRCA) or multiple genes (analyzed simultaneously with NGS), such as with multi-gene panels.

World Gets Closer to Identifying Cancer’s Genomic Drivers

 

Some highlights from the genome report include:

The average cancer genome is driven by four or five cancer-causing mute.
 - Approximately 13% of cancer-related mutations were found in non-coding DNA, or portions of the genome that don’t code proteins.
 - Many cancer-causing mutations occur years prior to a cancer diagnosis, indicating the need to increase early detection and screening efforts.
 - The mutations were seen in nearly 100 different molecular processes, all with unique mutational signatures.
 - Some signatures were associated with known cancer causes, including aberrant DNA repair and exposure to carcinogens like tobacco smoke or UV light. Other signatures were unexplained, suggesting that far more research needs to be done.

Testing in the Era of Precision Oncology

This ONS Voice article describes how every cancer diagnosis is as individualized and unique as the person receiving it.

Topics include:
 - understanding testing in practice
 - common misconceptions
 - types of targeted therapies
 - resources including online courses, guides, and published articles on personalized medicine

ONS Genomics Taxonomy

Genomics Taxonomy

The ONS Genomics Taxonomy is compiled of 89 foundational genomic terms categorized into six groups that provide standardized genomic language for oncology nursing practice and promotes understanding of genomic concepts that reflect the state of the science.

Using a Genomics Taxonomy: Facilitating Patient Care Safety and Quality in the Era of Precision Oncology

 

The ONS Advisory Board has selected additional genomics information and resources from respected authorities across the web, review that collection in the drop-down below. 

Genomics External Resources

Practice Resources

    NIH U.S. National Library of Medicine – MedlinePlus Genetics

    MedlinePlus adds detailed information about the effects of genetic variation on human health to its extensive collection of health and wellness information. Patients and their families and friends can now find even more easy-to-understand health information in one place at the NLM. MedlinePlus covers more than 1,300 genetic conditions and 1,400 genes, all of the human chromosomes, and mitochondrial DNA (mtDNA).

    Cancer Genetics Overview (PDQ®)–Health Professional Version

    Includes information on genetic counseling, familial cancer susceptibility syndromes, genetic analysis, clinical sequencing, and much more.

    Global Genetics and Genomics Community (G3C)

    The G3C (Global Genetics and Genomics Community) learning portal presents a bilingual collection of interactive cases that demonstrate how genetics and genomics link to health and illness. G3C is free to all users and encourages students and practicing healthcare providers to address the multi-dimensional needs of patients through various self-guided, video-taped "patient-provider" interview simulations.

    Oncology focused cases include Gabe, Grace, Jeff and Maria, Luis, and Tom

    Genetics/Genomics Competency Center (G2C2)

    • Online repository of genomics educational materials
    • Peer-reviewed collections for genetic counselors, nurses, pharmacists, physician assistants, and physicians
    • Professional editorial board curates every resource
    • Resources are mapped to discipline-specific genomic competencies

    Essential Genetic and Genomic Competencies for Nurses with Graduate Degrees

    This document identifies essential genetic and genomic competencies for individuals prepared at the graduate level in nursing. These competencies apply to anyone functioning at the graduate level in nursing, including but not limited to advanced practice registered nurses (APRNs), clinical nurse leaders, nurse educators, nurse administrators, and nurse scientists.

    Nurse Genetics/Genomics Competencies

    This document identifies the minimum knowledge and skill a nurse needs to be prepared to deliver competent genetic and genomic focused nursing care.

    Method for Introducing a New Competency: Genomics (MINC)

    A resource for nurse educators and administrators interested in integrating genomic competency into nursing practice. Content provided includes:

    •  Action plan and steps in the process
    •  Strategies
    •  Genomic education resources
    •  Evaluation and sustainability
    •  Challenges and potential solutions

    Learning Tools

    Jackson Laboratory

    Jackson Labs offer ‘free’ and ‘for pay’ CNE and CME educational modules and mini courses for all healthcare providers related to genomics and applications in practice. Topics include:

    •  Genetic cancer risk assessment
    •  Genetic testing technologies and understanding results
    •  Breast cancer
    •  Lynch syndrome/Colorectal cancer
    •  Pediatric neurology
    •  Germline and somatic testing

    National Human Genome Research Institute (NHGRI): Cancer Genomics

    Learn more about genomics, using the genome to treat cancer, blood tests to detect cancer, family risk and additional resources.

    Precision Medicine Advisors (PMA)

    PMA specializes in communicating precision medicine to lay professional audiences, providing scientifically sound, unbiased information to promote the responsible use of genomics in medicine. ‘Free’ and ‘For Pay’ CME/CNE education opportunities are available.

    Learn Genetics

    Interested in learning the basics of genetics? The University of Utah's Genetics Science learning Center provides a wide range of resources and short-engaging videos to help you learn about the basics of genetics, traits, DNA, chromosomes, genes, inheritance, and more.

    Patient Education

    National Cancer Institute – Biomarker Testing for Cancer Treatment

    Patient friendly website that includes information on what is biomarker testing for cancer treatment, how is it used to select cancer treatment, different types of biomarkers, and much more.

    What you need to know about biomarker testing (Lung Cancer Treatments)

    This brochure will help the patient:

    • Understand what a biomarker is
    • Learn how biomarkers are used to make lung cancer treatment decisions
    • Understand how biomarker testing is done
    • Consider whether you should have biomarker testing

    Biomarked

    Patient friendly website for patients with colorectal cancer to understand their biomarkers and what that means for their treatment

    Facing Our Risk of Cancer Empowered (FORCE)

    A website geared for those with hereditary breast, ovarian and related cancers.  Learn about genes and cancer, signs of hereditary cancer, genetic counseling, types of genetic tests and what results mean for patients and their and families.

    Cancer Support Community: Speaking Frankly about Precision Oncology

    Patient-friendly videos on precision medicine, targeted therapies, inherited cancers and biomarkers are featured. Companion downloadable PDFs are provided. In addition to precision oncology resources, free patient education publications on other cancer topics are available to download in multiple languages including English, Spanish, Chinese, Korean, Russian, and Vietnamese.