Cancer Care

I.Solid tumour oncogenetics

The UF-OG Unit is the national reference expert center in oncogenetics for all sites of the Cancer Institute AP-HP. Nord; it is located in Saint-Louis Hospital. Our comprehensive center and its local laboratory partner for tumor genomics, the oncogenetics unit led by Pr. Mourah, are both affiliated to the national French Group “Groupe Génétique et cancer” (GGC). In addition to the main site, there are currently two “associated centers”: one at Beaujon Hospital, specializing in pancreatology, and the other at Bichat Hospital, specializing in digestive oncology; both operate under the UF-OG geneticist’s delegation of responsibilities. Patients are referred to our center according to regional, national, and international guidelines. The Unit is fully computerized using MediFirst-Genetics software and online solution with a fully secured access. The UF-OG is in charge of multidisciplinary tumor boards (MTB) in oncogenetics. There are currently two main paths for patients to engage into an oncogenetics process (see below flowchart as Figure #1):

1. Either a known family history of cancers, a fortiori with cases over several generations;
2. Or, following somatic genomic analysis of a tumor, the identification of a genetic variant likely to qualify as germline with allele frequency close to or above 50% (Mandelker et al., 2019).

Regardless of the initial access mode, patients are referred to genetic counselling, and a pedigree must be drawn in order to further investigate the eventuality of a hereditary germline pathogenic variant along with associated tumor risks. The geneticist and/or the genetic counsellor (see recent update of the Bioethics law in France) gather(s) family members’ medical files. Germline genetic testing is offered according to the French NCI (INCa) recommendations for testing, provided that the patient has fully understood the information note and signed the informed consent. Beyond the above-mentioned inherited genetic cancer predisposition syndromes, our activity also extends to family predisposition to prostate cancer and endocrine tumors (MEN). At Beaujon Hospital, Dr. Louis de Mestier is in charge of the oncogenetics consultation for neuroendocrine malignancies (30 new patients/year) and familial pancreatic cancers (105 BRCA families identified and followed up).

II.Haemonc oncogenetics

As of 2021, a novel administrative unit (Unité de gestion UG694) has been set up as part of the hematology department. Dr. Marie Sébert is in charge of the clinical side, which specializes in the diagnosis of inherited predisposition to malignant myeloid hemopathies, and works in tight collaboration with the Laboratory of hematology led by Pr. Jean Soulier and Pr. Emmanuelle Clappier, in charge of myeloid tumor screening within the national program “France Médecine Génomique” (PMFG 2025).

It is intended for patients with family predisposition to myeloid hemopathies (4 new patients/month, 50/year), including the following:

• Acute myeloid leukemias (AML)
• Bone marrow failures
• Myelodysplastic syndromes (MDS)
• Myeloproliferative syndromes (MPS)

III. Rare disorders with potential involvement in oncogenetics

• • Telomeropathies and Gorlin syndrome (60 new patients/year), with biological analysis at the national reference laboratory (LBMR) constitutional oncogenetic biology unit, as part of the genetic department at Bichat Hospital.
  • This laboratory is part of the national network “Groupe Génétique et Cancer (GGC)”. The unit works in collaboration with the “FIMARAD-Filière Santé Maladies Rares Dermatologiques” and with the PREDIR center for renal cancers. Most of the diagnosed cases are referred from university hospitals, regional hospitals, and cancer centers from all over France. The unit is involved in the multidisciplinary PFMG pre-indication setting: “Maladies rares oncogénétiques Cancers avec antécédents familiaux particulièrement sévères”.

  https://pfmg2025.aviesan.fr/professionnels/preindications-et-mise-en-place/cancers-contexte-antecedents-familiaux-tres-severes-evocateurs-de-predisposition/