Genomic technologies, including targeted sequencing, and more recently, whole genome sequencing (WGS) have generated unprecedented insights into the molecular basis of disease. The application of WGS to patients with rare Monogenic Disorders is now identifying a molecular diagnosis in approximately 50 per cent of patients. The ability for WGS to characterise structural variants (SV) has redefined the genomic landscape of many cancers, providing treatment insights that were not possible from targeted sequencing approaches alone. One of the greatest challenges for precision medicine is the translation of bioinformatic methods developed in the research setting, often to study cohorts, into the clinic. Methods must be accurate, fast, comprehensive, interpretable by a multidisciplinary team, and must apply to the n-of-1 patient-centred situation.
The purpose of this proposal is to improve the clinical management of patients with inherited genetic disease, through increasing the diagnostic yield in rare disease, or improved tumour characterisation. The objectives of the proposal are to continue to develop a suite of bioinformatic approaches to uncover different aspects of genome biology and assess how these influence disease, and ultimately to translate these methodologies into clinically accredited tests. Many of these aspects of genome biology can only be uncovered by WGS. As we have already developed Australia’s first clinically accredited^ WGS-based diagnostic test for investigating single nucleotide variants (SNVs) and small insertions and deletions, we are uniquely positioned to achieve these objectives.
This proposal will develop critical bioinformatic and translational capability to improve patient care in NSW, and beyond.