Cancer Genomics and Personalized Medicine: A Q&A with City of Hope’s Joanne Jeter, M.D.

Understanding that every patient has a unique story, Joanne Jeter, M.D., medical oncologist and clinical professor, Department of Medical Oncology & Therapeutics Research at City of Hope, is dedicated to making a positive impact through her expertise in clinical cancer genomics. She is passionate about helping patients manage their genetic risk, providing education on their options to enable more informed decisions and guiding their family members in addressing their own cancer risk.

On choosing to join City of Hope, Dr. Jeter remarked, "As I saw more and more of my respected colleagues gravitate to the program at City of Hope and heard about the leading-edge work they strive to do, I knew I wanted to be a part of it.”

Among her new roles at City of Hope, Dr. Jeter has joined the distinguished faculty for City of Hope’s Intensive Course and Clinical Cancer Genomics Community of Practice (CCGCoP), an internationally recognized and awarded program to train and provide ongoing point-of-care support to help physicians and other health care providers integrate the latest advances in cancer genetics into clinical practice.  She is also working closely with CCGCoP director, Kathleen Blazer, Ed.D., M.S., and the program’s advisory committee, to bring the latest in precision medicine to the course curriculum. Applications to the upcoming session of the Intensive Course are being accepted through August 1. Coincidently, it all comes full circle because Dr. Jeter completed the Intensive Course and became a member of the CCGCoP in 2008, an experience that gave her a solid foundation to build her career as a researcher and cancer genomics expert. Her research has received funding from the National Cancer Institute, SWOG (formerly the Southwest Oncology Group) and the American Society of Clinical Oncology (ASCO). Just before joining City of Hope in 2023, Dr. Jeter was named a fellow of ASCO.  

As an essential member of City of Hope’s cancer genomics team, we were eager to hear about her experience with the Intensive Course and CCGCoP and its significant impact on patients and families.  

You completed the Intensive Course and joined the Clinical Cancer Genomics Community of Practice (CCGCoP) in 2008. In your experience, what has been the most valuable aspect of being a member of this unique community? And what is its value to your practice and professional development? 

The Intensive Course was formative for me in my career. It allowed me to have updated training in cancer genetics after I had completed my medical oncology fellowship. In my mind, the community that has formed around the Intensive Course is a unique and priceless resource for those practicing in this area. Most physicians and nurse practitioners in cancer genetics come from an oncology specialty, a surgical specialty or a medical specialty rather than having extensive genetics training, and there is no common training pathway for them. This course helps to prepare providers in these situations for the practice of risk assessment, interpretation of genetic testing and management of those with hereditary cancer predisposition syndromes. Having a community of providers from various backgrounds and practice situations allows access to different perspectives for challenging cases and situations. Although genetic counselors have long had a robust community for discussion through the National Society for Genetic Counselors, having CCGCoP for those who are not genetic counselors is invaluable. It also aids in making referrals for patients' family members who live in different geographic locations. 

As an Intensive Course alumnus, what are you most excited about in your new role as faculty and advisory committee member for the program? 

Where to begin? I am thrilled to be able to contribute to a program that has given me so much. I strongly believe that all oncology practitioners need to have a good working knowledge of cancer genetics, as tumor testing with implications for hereditary genetics has become more widespread and inherited genetic results are increasingly influencing treatment decisions for cancer. "Mainstreaming" of genetic testing into oncology practices is becoming more common, and we have a responsibility to prepare trainees and practitioners for this new aspect of their patient care. I am particularly excited about the ability to help train those in other countries and underserved areas. And, at the end of the day, we all learn from each other. It can be so refreshing to see the perspectives of the learners and identify new approaches and questions. 

What do you consider the greatest impacts of genetic cancer risk assessment and genetic testing on City of Hope’s patients and their families? 

We consider the family in our assessments, in addition to the needs of the patients. Assessing risk can help determine who is at increased risk and needs increased screening or even medications or procedures to help reduce that risk. In addition, by helping to quantify risk, we can sometimes reassure patients that their risk is lower than they previously thought. Genetic testing can help us determine which cancers are most likely or have the highest risk for an individual or family. Sometimes we identify risks through testing that were not suspected clinically on the basis of personal and family history alone. In addition, if an inherited genetic change is identified in a family, we can use testing to determine who does have the change and is at increased risk, as well as those who do not have the genetic change and do not require additional screening. I like to call this a ripple effect. Finding an inherited change in one person can help us take the best care of the entire family. 

What role does the Intensive Course and CCGCoP play in expanding the access to these services to patients across the U.S. and around the world? 

The first impact of the course is simply spreading this knowledge, often to areas where this information may not otherwise be easily obtainable. One of my mentees from Mexico was in the last cohort, and I encourage my ASCO international mentees to participate every year. The community of practice literally has contributors from across the globe, in 37 countries ranging from Brazil to Switzerland to Nigeria. By empowering and educating the providers, we can help make risk assessment and management more available to the patients they serve. The ongoing conversations in the community of practice allow updates and new data to be disseminated easily, as well as providing perspectives from different geographic locations and populations. 

Who should consider taking the Intensive Course, and how do they apply? 

In my totally unbiased opinion, I think all oncology trainees and practitioners should take it! But seriously, it is best for anyone who has an interest in risk assessment and management or who wants to order their own genetic testing for inherited cancer predisposition disorders. Some specialties, such as breast surgery or gynecologic oncology, have relevance given what we know about hereditary aspects of these cancers. Although this is a great course for physicians, I would love to see more representation from oncology nurse practitioners and physician assistants, as I feel this is a great area for advanced practice providers as well.  

For those interested in the Intensive Course 2025 cohort running October 2024 to February 2025, I recommend applying online here. Deadline is August 1. Additionally, Dr. Blazer and her team are happy to answer any questions about the course and the CCGCoP. Email cgep@coh.org. I hope to see many of you in the program this fall!