Tuesday, June 5
7:45 am Registration & Morning Coffee
Employing Existing Cancer Biomarkers and Questing for New Ones
8:45 Chairperson’s Opening Remarks
Pei Hui, M.D., Ph.D., Associate Professor, Pathology, Clinical Director, Molecular Diagnostic Laboratories, Department of Pathology, Yale University School of Medicine
8:50 Genetically Informed Cancer Medicine
Cindy L. Vnencak-Jones, Ph.D., FACMG, Professor, Departments of Pathology and Pediatrics; Director, Molecular Diagnostics Lab, Vanderbilt University Medical Center
Long term survival for patients with metastatic cancer is often poor. Newly developed targeted therapy against mutant signaling proteins have demonstrated promising anti-tumor activity in a subset of patients whose tumors harbor specific alterations. Using a multidisciplinary team approach, we have developed and implemented tumor specific molecular profiling assays in the clinical molecular diagnostics lab to improve the clinical outcome of our patients. This service is facilitated by automated reporting in the electronic medical record and is associated with online decision support services for our clinicians.
9:20 BRAF Mutation Testing in Clinical Practice of Oncology
Pei Hui, M.D., Ph.D., Associate Professor, Pathology, Clinical Director, Molecular Diagnostic Laboratories, Department of Pathology, Yale University School of Medicine
High prevalence of BRAF mutation in melanoma, cancers of thyroid and colon, and hairy cell leukemia implies that the mutation is an important “driver” in the development of these malignancies. In addition to as a poor cancer prognostic indicator in general, BRAF mutation is a powerful diagnostic marker for thyroid cancer and hairy cell leukemia. Recent clinical trials of BRAF inhibitors are changing the treatment paradigm in patients with melanoma and other malignancies. Highly sensitive and specific BRAF mutation testing is essential for the current clinical practice of oncology.
9:50 Layered IHC Tests to Predict Tumor Response to Targeted Therapies: Two Successful Studies
John Gillespie, M.D., Director, Medical Affairs, 20/20 GeneSystems, Inc.
L-IHC permits the multiplex analysis of biomarkers in FFPE tissue sections. Analysis of biomarkers along the mTOR pathway using L-IHC was performed on breast and kidney cancer samples from patients treated with HERCEPTIN® (trastuzumab) and TORISEL® (temsirolimus), respectively. Two sets of biomarkers correctly identified 96% of TORISEL® responders and 82% of HERCEPTIN® responders, a substantial improvement over other tests used in clinical practice. These studies demonstrate the extraordinary power of L-IHC as a tool for personalized medicine.
10:05 Refreshment Break with Exhibit & Poster Viewing
10:35 The COXEN Principle: Translating in vitro Chemosensitivity Signatures into Tools for Clinical Outcome Prediction in Cancer
Dan Theodorescu, M.D., Ph.D., Paul A. Bunn Professor of Cancer Research, Professor of Surgery and Pharmacology; Director, University of Colorado Comprehensive Cancer Center
Substantial effort has been devoted to in vitro testing of candidate chemotherapeutic agents in cancer cell lines yet the yield from has been modest with only a handful of compounds entering clinical practice. Furthermore, identification of patients who will respond to various agents has been a challenge even when the target is known. We addressed these two challenges by developing the CO-eXpression ExtrapolatioN (COXEN) algorithm. This tool is a virtual “Rosetta Stone” that projects cell line drug sensitivity to human tumors and by virtue of this fact can be used for both drug discovery and patient selection for personalized therapy.
11:05 Next Generation Sequencing in Cancer: From Targeted Panels to Whole Exome
Madhuri Hegde, Ph.D., Emory University School of Medicine, Atlanta, GA
This presentation will focus on the new development in next generation sequencing and its impact on testing for cancer for germline and somatic mutations. A special focus will be on the data from Ion Torrent targeted sequencing approach in solid tumors and for genetic testing approaches to colorectal cancer.
11:35 Correlated Immunohistochemical and Cytological Assays for the Prediction of Hematogenous Dissemination of Breast Cancer
Maja Hrzenjak Oktay, M.D., Ph.D., Assistant Professor, Pathology, The L.G. Koss Division of Cytology, Department of Pathology, Montefiore Medical Center
Our ability to predict breast cancer metastasis is limited. This talk describes a new immunohistochemical approach for the assessment of metastatic risk based on the density of intravasation microenvironment sites called TMEM (Tumor MicroEnvironment of Metastasis). In addition, it describes an isoform assay for the actin regulatory protein Mena using FNA (fine needle aspiration) samples, and the details about how these two assays may be applied in clinical practice in a synergistic way to assess the risk of metastasis
12:05-1:15 pm Enjoy Lunch on Your Own
» 1:15 Keynote Presentation: Strategies for Routine, Large Scale Clinical Genotyping of Lung Cancers for Optimal Selection of Targeted Therapies
 Marc Ladanyi, M.D., The William Ruane Chair in Molecular Oncology, Attending Pathologist, Molecular Diagnostics Service, and Member, Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center
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1:45 From Bench to Clinical Lab, the Challenges in Assay Development for the Clinical Setting
Stephen M. Hewitt, M.D., Ph.D., FCAP, Clinical Investigator, TARP/AMPL, LP, CCR, NCI, NIH
Despite the substantial number of publications touting new biomarkers, their clinical introduction has been limited. Many of these biomarkers never make it out of the research laboratory, and when they do, they face a number of hurdles. Central to these issues are assay verification, and validation within the context of total test environment.
2:15-2:45 Refreshment Break with Exhibit
& Poster Viewing
2:45 Chairperson’s Opening Remarks
Stephen A. Boppart, M.D., Ph.D., Bliss Professor of Engineering, Departments of Electrical and Computer Engineering, Bioengineering, and Medicine, Beckman Institute for Advanced Science and Technology, University of Illinois
» 3:00 Keynote Presentation: Endoscopic Microscopy: Bridging the Radiology-Pathology Divide
 Guillermo Tearney, M.D., Ph.D., Professor of Pathology, Harvard Medical School; Associate Director, Wellman Center for Photomedicine, Massachusetts General Hospital
Endoscopic microscopy is a new field where microscopic images are obtained from living patients. This capability opens up possibilities for obtaining histopathologic diagnoses from tissues that are difficult or unsafe to sample, screening entire organs for occult microscopic disease, and understanding disease mechanisms in vivo. In this talk, I will describe some endoscopic microscopy techniques developed, including optical coherence tomography (OCT), optical coherence microscopy (OCM), and confocal microscopy (CM) and will discuss how these methods can potentially impact patient care.
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3:30 Feasibility of Confocal Fluorescence Microscopy for The Evaluation and Differentiation of Benign and Malignant Human Breast Tissue
Wei Tse Yang, M.D., Professor and Chief, Section of Breast Imaging Deputy Chairman, Department of Diagnostic Radiology The University of Texas, M.D. Anderson Cancer Center
Confocal fluorescence microscopy has the potential to be a valuable imaging technique to acquire high resolution images of fresh tissue when used in conjunction with an optical contrast agent such as proflavine. Proflavine is a topical fluorescent antiseptic which rapidly stains cell nuclei. In a pilot study, confocal fluorescence images of fresh human breast tissue specimens were visually compared to conventional histo-pathological slides. Findings were categorized as normal, benign lesions, and malignant in situ and invasive tumors. Breast tissue features in confocal fluorescence microscopy were interpreted using the criteria: 1) cell architecture and orientation, 2) nuclear spacing, 3) nuclear size, 4) staining patterns. Confocal fluorescence microscopy and standard histo-pathological preparation show histological features of breast tissue that are comparable in appearance. This optical imaging technique is rapid, inexpensive, and does not require extensive specimen preparation.
4:00 Label-Free Structural and Molecular Optical Coherence Imaging for Intraoperative Guidance in Breast Cancer Surgery
Stephen A. Boppart, M.D., Ph.D., Bliss Professor of Engineering, Departments of Electrical and Computer Engineering, Bioengineering, and Medicine, Beckman Institute for Advanced Science and Technology, University of Illinois
Rapid label-free approaches for structural and molecular imaging and histopathology have been developed based on broadband coherence imaging. Optical Coherence Tomography (OCT) provides images of microstructure based on backscattered light, while Nonlinear Interferometric Vibrational Imaging (NIVI) provides molecular histopathology images from vibrational signatures generated by coherent anti-Stokes Raman scattering (CARS). These coherence imaging technologies offer real-time intraoperative feedback, an alternative to traditional post-operative histological staining, and the potential for future in vivo label-free molecular histopathology.
4:30 Rapid Cancer Detection by Topically Spraying an Activatable Fluorescent Probe during the Surgery and Endoscopy Procedures
Hisataka Kobayashi, M.D., Ph.D., Chief Scientist, Molecular Imaging Program, NCI, NIH
In this talk, we will discuss the potential of fluorescence-guidance during surgery or endoscopy that will strongly assist defining the tiny cancer or the clear border between cancer and normal tissue for successful sampling of biopsy specimen and total resection of cancer. Additionally, a newly developed activatable probe, which can be activated within a minute after hitting cancer cells (and is therefore a good spraying application) will be introduced.
5:00 Panel Discussion: Intra-Operative Optical Imaging and In Vivo Microscopy: Trends and Applications
5:30 END OF CONFERENCE
