Genomics is rapidly pushing oncology closer to an actualized version of precision medicine.1,2 In the era of poly (ADP-ribose) polymerase inhibition and immunotherapy, genetic testing may yield information that will affect therapeutic choices, in addition to informing the patient about personal and familial risk. This article addresses (1) current guidelines for germline testing, (2) key aspects of testing and counseling, (3) a road map for genetic testing and counseling delivery, (4) challenges of testing and possible solutions, and (5) benefits and limitations of testing.

In 2016, the Genetic Counselor Workforce Working Group estimated a growth of 72% in the workforce between 2017 and 2026, with demand not expected to meet population equilibrium until 2024-2030. In addition to detecting tumor-specific mutations, it can sometimes identify potential germline mutations. Most somatic testing platforms are not validated to distinguish germline from somatic-only mutations, even if paired testing with a blood or saliva sample is performed. 

All these considerations are very much interesting to take care of and they will help you with getting oncology to the next level.