Applying Genetic Science and Clinical Expertise to Strengthen Comprehensive Care

Kadance Pharmacogenomic (PGx) Testing

What Does a PGx Test Assess?

Pharmacogenes encode enzymes that control how medications are transported and metabolized in the body, impacting individual responses to those medications. Drug transport enzymes affect how medications are absorbed, distributed, and eliminated by the body, controlling the amount of drug that reaches its target. In contrast drug metabolism enzymes are responsible for how quickly or slowly the body processes and breaks down drugs, which can impact a medication’s potency or duration of effect. Pharmacogenes play a vital role in determining how effectively a drug will work for an individual, guiding more personalized and safer treatment options.

Drug Transportation Enzymes

Drug Metabolizing Enzymes

Our PGx test focuses on AMP Tier 1 alleles. Additional scientifically significant pharmacogenes are also included in the test.

PGx Genes Tested are Chosen Based on Strong Scientific Evidence:

Leading scientific organizations that issue guidance on Pharmacogenomics:
CPIC (https://cpicpgx.org/)

PharmVar (https://www.pharmvar.org/)

AMP Tier 1 & Tier 2 Gene Variants (https://www.pharmgkb.org/ampAllelesToTest)


Our PGx Test Validation Data



Pharmacogenomics can help prevent adverse drug reactions (ADRs), which result in over 1.5 million emergency room visits per year in the U.S. (CDC, 2024). A study showed that genetic testing before prescribing medications could reduce ADRs by 30%. (Swen et al., 2023). 


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Kadance Hereditary Cancer Risk Testing


Hereditary cancer risk testing provides valuable insights by identifying individuals with a higher genetic likelihood of developing certain cancers. By examining variations in several key cancer-related genes in a single test, it offers a broad view of risk. A positive result enables proactive, personalized healthcare decisions, including customized screening plans with more frequent and targeted monitoring. This early vigilance can lead to the detection of cancers at earlier, more treatable stages, ultimately improving outcomes and potentially saving lives.

Lifetime Risk of Developing Cancer

Our hereditary cancer risk test covers all CDC Tier 1 genes plus other scientifically significant hereditary cancer risk genes.

Our Hereditary Cancer Risk Test Validation Data

*Variant concordance within full coverage range, where compared test results received sufficient sequencing coverage for genotype calling.

The Hereditary Cancer Risk Genes We Assess are Chosen Based on Strong Scientific Evidence:

ClinGen’s Hereditary Cancer Gene Curation Expert Panel (https://search.clinicalgenome.org/kb/affiliate/10023) 

ClinVar (https://www.ncbi.nlm.nih.gov/clinvar/)

CDC Tier 1 Genes (https://archive.cdc.gov/www_cdc_gov/genomics/implementation/toolkit/tier1.htm)
NCCN Guidelines (https://www.nccn.org/guidelines/category_1)


Early cancer detection rates are increasing through hereditary risk testing. Detecting cancers at an early stage versus a late stage has a dramatic impact on survivability.  Five-year relative survival for localized stage cancers is 91.1% vs. 30.6% for distant stage cancers (SEER Survival Statistics, 2017). By identifying genetic predispositions, precision health enables the implementation of preventative measures. 


An estimated 90–97% of at-risk BRCA1/BRCA2 carriers in the population remain unidentified (Manchanda et al., 2018).Genetic testing for BRCA mutations in breast cancer has led to 87% higher early detection rates among at-risk women, enabling timely interventions (Rosenberg et al., 2016).



Individuals with Lynch Syndrome, characterized by specific mutations in the MLH1, MSH2, MSH6, PMS2, or EPCAM genes, face an elevated risk of developing early-onset colorectal and endometrial cancers, as well as gastric and ovarian malignancies. Current guidelines recommend that these individuals begin regular colonoscopy screenings at a younger age than the general population to facilitate early detection and prevention (Bhattacharya et al., 2024).


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Clinical Pharmacy Services

We work directly with your healthcare team to review your medications, identify potential interactions with other drugs, your diet, or your genetic makeup, and ensure your treatment plan is safe and effective.

Medications should never be adjusted without talking with your healthcare team.



Today, there are more ways than ever to understand your health and take better care of yourself. According to a 2021 study, 64.8% of U.S. adults aged 18 and older took prescription medications within the past year (National Center for Health Statistics, 2021). A key part of staying healthy is ensuring your healthcare team understands how your medications may interact with each other, your diet, or even your genes, and manages them safely.

If you take several medications, see more than one doctor, or have certain health conditions, it’s important to keep track of all your medications. This can help prevent potential problems caused by drug interactions, which might:

• Make your medication less effective
• Cause unexpected side effects
  
• Increase the effects of a drug, potentially causing harm

The Five Categories of Drug Interactions

Drug-Drug Interactions

Drug-drug interactions happen when two or more medications react with each other. This can lead to unexpected side effects or changes in how the drugs work (FDA, 2013).

Drug-Food/Beverage Interactions
These occur when a medication interacts with certain foods or drinks, potentially changing how the drug works in your body (FDA, 2013).

Drug-Condition Interactions
Some medications can be harmful if you have specific health conditions (FDA, 2013).

Drug-Gene Interactions
Your DNA can influence how your body responds to medications. Your genes may determine if a drug works well for you, causes side effects, or has no effect at all (Verbeurgt et al., 2014).

Drug-Drug-Gene Interactions
These occur when medications and your genes interact to change how drugs are processed in your body (Verbeurgt et al., 2014).

Our clinical pharmacy service takes an individual’s pharmacogenomic data, current medications regimens, and current health conditions to calculate a medication risk score and prepare a medication optimization report for your healthcare team. This report identifies any potential areas of medication safety concerns. Analysis of over 427,000 patients found that higher medication risk scores were linked to a greater chance of dying, especially in younger age groups. For example, people aged 30–49 with higher scores were nearly eight times more likely to die compared to those with lower scores. Older adults also faced higher risks, but the impact was less extreme than for younger patients (Ratigan et al., 2021).

Medications should never be adjusted without talking with your healthcare team.



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Post-Diagnostic Services

Oncology Nurse Navigators

Our Oncology Nurse Navigators (ONNs) provide compassionate guidance to members after a cancer diagnosis, making a challenging journey feel more manageable and improving care outcomes. Timely navigation, within 30 days of diagnosis, cut diagnostic resolution time half compared to delayed navigation according to one study (Wells et al., 2012). A study at Northwell Health Cancer Institute found that 38% of breast cancer patients without a nurse navigator stopped receiving treatment within that hospital system. In the first 6 months of the introduction of a nurse navigator program, they increased the percentage of surgical patients who remained with them from diagnosis to consultation from 62% to 91% (14th Annual AONN+ Conference Abstracts, Oct 2023).


Oncology Nurse Navigators are invaluable allies, offering care and clarity every step of the way.

Second Opinion Pathology Review

Second opinions in oncology are essential for ensuring diagnostic accuracy and optimizing treatment plans, potentially altering the trajectory of a patient’s care.

At MD Anderson Cancer Center, pathologists refine initial diagnoses from other institutions up to 25% of the time, underscoring the importance of specialized expertise in re-evaluating complex cases (MD Anderson Cancer Center Institutional Profile). Similarly, a study conducted at Memorial Sloan Kettering Cancer Center demonstrated that second opinions resulted in clinically meaningful changes in treatment in 35% of cases. These changes often improved expected morbidity or prognosis, not through new diagnoses but by refining treatment plans. Adjustments included reducing or eliminating unnecessary surgeries, shifting from aggressive interventions to observation, and tailoring systemic or radiation therapies. Diagnostic changes, although less frequent (11%), were pivotal when they occurred, often driven by comprehensive reviews or advanced diagnostic techniques (Lipitz-Snyderman et al., 2023).These findings affirm the critical value of second opinions in oncology, emphasizing their role in reducing treatment-associated risks, ensuring alignment with the latest clinical guidelines, and enhancing overall patient outcomes. Patients facing a cancer diagnosis can benefit significantly from consulting outside oncology experts for a second opinion.

Genetics of Cancer

Cancer is fundamentally a genetic disease caused by alterations in the genes that regulate how cells grow and divide.



Each cell in your body contains copies of your genes. Genes are specific sections of DNA that carry instructions for making proteins or sets of proteins, which are essential for your body's functions. Researchers have identified hundreds of genetic and DNA changes—often referred to as mutations, variants, or alterations—that contribute to the development, growth, and spread of cancer.

Genetic changes linked to cancer can arise due to:

• Random errors in DNA during cell division
• Environmental carcinogens, such as chemicals in tobacco smoke, ultraviolet (UV) radiation, or infections like the human papillomavirus (HPV)
  
• Inherited mutations passed down from a parent

These DNA alterations occur throughout life, even before birth. While most genetic changes are harmless, the gradual accumulation of these alterations over time can transform healthy cells into cancerous ones. The majority of cancers result from this gradual process and occur by chance (National Cancer Institute, The Genetics of Cancer, 2024).

This is an excellent resource on the genetics of cancer from the National Cancer Institute: https://www.cancer.gov/about-cancer/causes-prevention/genetics


NCI’ pages for healthcare professionals:

Overview: https://www.cancer.gov/publications/pdq/information-summaries/genetics/overview-hp-pdq
There is a list of specific cancer types and their genetics for healthcare providers here:
https://www.cancer.gov/publications/pdq/information-summaries/genetics

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Genetic Privacy

We prioritize your privacy and the security of personal health information. Our practices fully comply with HIPAA regulations, ensuring that personal data remains protected at all times. We are also SOC2 compliant, demonstrating our commitment to stringent data security standards. We never sell or share your information with any third parties, including insurance carriers, employers, or healthcare systems. For further details, please refer to our Privacy Policy. Additionally, in 2008, the U.S. federal government passed the Genetic Information Nondiscrimination Act (GINA) into law to protect individuals from employment and health insurance discrimination based on genetic data.



We believe that protecting and safeguarding personal data is of the utmost importance. To that end, Kadance has implemented multiple layers of security to protect member data, including the encryption of all personal data and restriction of data access to essential personnel only.Please refer to our privacy policy for more information.