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Genomic Medicine at Avera Cancer Institute

A specialized team, coupled with Avera’s collaborative spirit, has brought Genomic Oncology to the Northern Plains. Before, this level of care was available only at large metropolitan national cancer centers.

Led by Brian Leyland-Jones, MB, BS, PhD, Vice President of Molecular and Experimental Medicine, this team offers personalized cancer therapies to patients, based on their individual genomic profile.

Dr. Leyland-Jones is an internationally renowned cancer expert. Before joining Avera in January 2014, he was Director of Edith Sanford Breast Cancer Research. He came to Sioux Falls from Atlanta, Ga., where he was Executive Vice President and Director of the Winship Cancer Institute and Chair of Hematology-Medical Oncology at Emory University School of Medicine. Dr. Leyland-Jones is the recipient of numerous research grants, and has served as principal, co-principal and co-investigator on more than 100 clinical studies.

A conversation with Dr. Brian Leyland-Jones:

Questions & Answers

Q: What is personalized medicine, and how long has it been available?

A: The genome is all the genetic information contained in your DNA, and it serves as an instruction manual for every cell in your body. This book has 6 billion letters arranged in 46 chapters.

Cells are constantly replicating, and the body has its own repair system when something goes wrong. For example, smoking just three cigarettes or sitting out in the sun too long can cause a single genetic mutation. Repetitive exposures will bring cumulative genetic changes that are so great and so rapid that repair processes are overwhelmed.

The science of medicine was transformed in 2001 with the sequencing of the first human genome. That was followed by the sequencing of the first cancer genome in 2009.

We can sequence the DNA in a tumor cell, and compare it to normal DNA in a blood cell. We compare both sequences to figure out exactly what changes took place at the cellular level, and match specific targeted therapy to these changes.

Q: Why is genomic science important in cancer care?

A: Our health is a combination of our DNA and our environment. Our DNA is that inherited “instruction manual” that makes us unique individuals. Our environment is comprised of what we eat, the microbes or chemicals we were exposed to, and so on. Understanding the genetic component is very powerful in identifying what causes human disease.

Q: What patients are you working with at Avera?

A: We work with patients who have all types of cancer, with a specific focus on breast cancer that is metastatic or resistant to treatment.

Q: How is this care different than a typical approach?

A: Doctors typically prescribe cancer treatment based on what we think will work for a particular type of cancer. The trouble is, we commonly don’t know until several weeks or months into the treatment whether it’s working or not.

With personalized medicine, we can better predict up front what treatments are likely to work, or more importantly, what treatments are likely not to work.

Q: Are there other programs like this in the United States?

A: Yes and no. Genomic oncology programs typically exist at large national cancer centers, and ours is similar in several ways. Yet Avera’s program is set apart by several factors. First, most programs use only one type of test – or platform – to find genomic changes. We use multiple tests to be as precise as possible. We’re also set apart by the diversity of our team and our collaborative partners, and our aggressive approach to match targeted therapy to genetic changes.  We’re committed to a 14-day turnaround time whenever possible, when most programs might take up to three months to provide answers.

Right here in the Northern Plains, we are building a genomic oncology program that rivals any other program worldwide. Regionally, there is no other cancer program offering this level of care.

Q: What actually takes place with personalized medicine?

A: Patients are referred to our program, or they can also self-refer by contacting Avera Medical Group Oncology & Hematology at 605-322-6900. If the decision is made to go ahead with genomic sequencing:

  • We send samples from the tumor biopsy and blood tests to both the pathology lab at Avera McKennan, and Avera’s specialized Genomic Oncology lab. This lab is located in La Jolla, Calif., to be closer to the top experts who collaborate with us.
  • DNA is extracted from the tumor cell and normal cell.
  • DNA samples are sequenced and compared to find changes.
  • Experts on a multidisciplinary sequencing tumor board match targeted therapy to genetic changes. This tumor board makes a recommendation to Avera Cancer Institute’s disease specific conferences.
  • The clinical team in Sioux Falls collaborates with Avera oncologists to carry out the treatment plan.

Q: Who makes up the genomic medicine team?

A: Our diverse team of experts includes a clinical physician, doctor of pharmacy, research scientists, experts in bioinformatics, nurse practitioners and more. We also collaborate with many of the top experts in the world. Cancer patients we work with have a tumor board of around 40 people looking at their particular case.

Q: What’s the future of personalized medicine in cancer care?

A:This type of care is still mostly in the research phase. In the future, it will absolutely revolutionize cancer care. Five years from now, it will be routine for cancer patients to have genomic testing soon after diagnosis, so cancer treatment can be matched to the cell changes early on in the cancer care journey.  We are excited that Avera is investing in this field now to offer more hope for treating cancer effectively.

*Coverage for genomic medicine varies among insurance providers.

Our Team

Brian Leyland-Jones, MB, BS, PhD

Brian Leyland-Jones

Dr. Leyland-Jones is an internationally renowned breast cancer expert, a consulting Professor for the Division of Oncology at Stanford University School of Medicine, Professor in the Department of Internal Medicine at the Sanford School of Medicine at the University of South Dakota and Vice President of Molecular and Experimental Medicine at the Avera Cancer Institute.

Dr. Leyland-Jones was most recently Director of Edith Sanford Breast Cancer Research in Sioux Falls, S.D. He came to Sioux Falls from Atlanta, Ga., where he was Executive Vice President and Director of the Winship Cancer Institute and Chair of Hematology-Medical Oncology at Emory University School of Medicine. He was named both the Georgia Research Alliance Eminent Scholar and Georgia Cancer Coalition Distinguished Cancer Scholar.

Dr. Leyland-Jones earned biochemistry, medical and PhD degrees from the University of London. After postgraduate training in London, he completed fellowships in medical oncology and clinical pharmacology at Memorial Sloan-Kettering Cancer Center and Cornell University Medical College, and then went on to become an Assistant Professor in both disciplines at both institutions. Dr. Leyland-Jones subsequently served as head of the Developmental Chemotherapy Section at the National Cancer Institute, and then as founding Chairman of the Department of Oncology, Minda de Gunzburg Chair in Oncology, Professor of Medicine and Oncology, and Director of the McGill Comprehensive Cancer Center at McGill University in Montreal, Quebec.

Dr. Leyland-Jones is the recipient of numerous research grants, and has served as principal, co-principal and co-investigator on more than 100 clinical studies. He has authored and co-authored more than 170 peer-reviewed articles and book contributions, 23 books and book chapters, 286 abstracts and 34 patents.

Casey Williams, PharmD, BCOP is Director of Molecular and Experimental Medicine.

Casey Williams

He holds a doctor of pharmacy degree from Creighton University School of Pharmacy and Allied Health Professions, and a bachelors of science degree in biology and chemistry from Buena Vista University of Storm Lake, Iowa.



Dr. Williams serves as clinical associate professor for the University of South Dakota Sanford School of Medicine Department of Internal Medicine, as adjunct clinical assistant professor for the University of Kansas School of Pharmacy, and as adjunct clinical assistant professor for the South Dakota State University School of Pharmacy. Over the past five years, he has been involved in nearly 20 research studies, and reviews manuscripts for multiple major medical journals. He has written over 30 published articles and book chapters, and has given numerous lectures and presentations. Dr. Williams also serves in leadership roles on multiple committees for medical and pharmacy organizations including ASHP, ACCP, HOPA, ECOG, and the Board of Pharmaceutical Specialties.

Meet Dr. Brian
Leyland-Jones

Dr. Brian Leyland-Jones, Vice President of Molecular and Experimental Medicine at Avera McKennan, leads the applied genomics team that specializes in scientific and medical aspects of cancer.

View his profile

Meet Casey Williams, PharmD

Casey Williams, PharmD, BCOP, is the Director of Molecular and Experimental Medicine at Avera McKennan.