ASCO: You’re listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world’s leading professional organization for doctors who care for people with cancer. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guests’ statements on this podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Cancer research discussed in this podcast is ongoing, so data described here may change as research progresses. Greg Guthrie: Hi, everyone. I'm Greg Guthrie, and I'm a member of the Cancer.Net content team, and I'll be your host for today's Cancer.Net podcast. Cancer.Net is the patient information website of ASCO, the American Society of Clinical Oncology. Today, we're going to be talking about the ASCO provisional clinical opinion, “Somatic Genomic Testing in Patients With Metastatic or Advanced Cancer.” Our guests today are the co-chairs of the team that wrote these recommendations. Dr. Funda Meric-Bernstam from the University of Texas MD Anderson Cancer Center in Houston, Texas. Thank you for joining us today, Dr. Meric-Bernstam. Dr. Meric-Bernstam: Thank you for having us. Greg Guthrie: And our second guest today is Dr. Mark Robson from Memorial Sloan Kettering Cancer Center in New York City. Dr. Robson, thank you for joining us today, too. Dr. Robson: Thank you for having me. Greg Guthrie: So before we begin, I should mention that Dr. Meric-Bernstam does not have any relationships to disclose related to this podcast. Dr. Robson has led clinical trials in PARP inhibitors but has not received any personal compensation for this research. Full disclosures for this podcast can be found on Cancer.Net. So, Dr. Robson, let's begin by discussing what a provisional clinical opinion is and why they are important. Dr. Robson: So there are times when there are sea changes or incredibly important changes taking place in oncology practice. And sometimes these are clinical trial data, and sometimes they are more global. And this is a situation where it's one of those global challenges. And what ASCO does in situations like this is pull together a group of experts to provide guidance for the membership through a process of discussion and informal consensus rather than necessarily direct evaluation of clinical studies. And this is important because it allows the membership to benefit from these expert opinions. Greg Guthrie: Now, Dr. Meric-Bernstam, this provisional clinical opinion discusses somatic genomic testing in metastatic or advanced cancer. What is somatic genetic testing, and how is it used in cancer treatment? Dr. Meric-Bernstam: Oh, thank you. This is a really exciting time in the last decade. We have a lot more tools to understand cancer biology. And cancer is a genomically-driven phenomena, where there's alterations in the DNA, in the tumor, that confers the cancer cells a competitive growth and survival advantage. And only 10 years ago, we had the capability of doing this 1 gene at a time, to sequence a gene to see what is different, but now we have technologies where we can look at several hundred genes at a time. We are referring to these as multigene panels. And we're talking about genomic testing or somatic genomic testing. These are tests that look at several hundred genes, either looking at the tumor sequence alone or looking at the tumor sequence and comparing it to the normal sequence so we can see what has differed in the tumor that may give it a competitive advantage. We're doing this to be able to identify if there are genes that are altered that are therapeutically actionable. What we mean by that is, is there