Real Time Coverage Morning Session on Precision Oncology: Advancing Precision Medicine Annual Conference, Philadelphia PA November 2 2024
Reporter: Stephen J. Williams, Ph.D.
9:20-9:50
How Can We Close the Clinical Practice Gaps in Precision Medicine?
Susanne Munksted, Diaceutics
Studies are showing that genetic tests are being ordered at a sufficient rate however it appears there are problems in interpretation and developing treatment plans based on omics testing results
- 30 % of patients in past and now currently half of all patients are not being given the proper treatment based on genomic testing results (ASCO)
- E.g. only 1.5% with NTRK fusions received a NTRK based therapy (this was > 4000 patients receiving wrong therapy)
- A lung oncologist may only see one patient with NTRK fusion in three years
Precision Medicine Practice Gaps
48% of oncologist surveyed agreed pathologist needs to be more informed and relevant in the decision making process with regard to tests needing to be ordered
95% said need to flip cost issues ; what does it cost not to get a test … i.e. what is the cost of the wrong therapy
We need a new commercialization model for therapeutic development for this new era of “n of one” patient
9:50-10:15
Emanuel Petricoin, George Mason University
There are some tumor markers approved by FDA that cant just be measured by NGS and are correlated with a pathologic complete response
- Many point mutations will have no actionable drug
- Many alterations are post-genomic meaning there is a post translational component to many prognostic biomarkers
- Prevalence of point mutation with no actionable mutation is a limit of NGS
- It is important to look at phospho protein spectrum as a potential biomarker
Reverse phase protein proteomic analysis
- Made into CLIA based array
- They trained centers around the US on the technology and analysis
- Basing proteomics or protein markers by traditional IHC requires much antibody validation so if the mass spectrometry field can catch up it would be very powerful
- With multiple MRM.MS there is too low abundance of phosphoproteins to allow for good detection
They conducted the I-SPY2 trial for breast cancer and determining if phosphoproteins could be a good biomarker panel
- They found they could predict a HER2 response better than NGS
- There were patients who were predicted HER2 negative that actually had an activated HER2 signaling pathway by proteomics so NGS must have had a series of false negatives
- HER2 co phosphorylation predicts pathologic complete response and predicts therapy by herceptin
- They found patients classified as HER2 negative by FISH were HER2 positive by proteomics and had HER2 activation
10:15-11:10
Liquid Biopsy MRD to Escalate or De-escalate Therapy (CME Eligible)
Adrian Lee, UPMC
Marija Balic, UPMC
Howard McLeod, Utah Tech University
Muhammed, Murtaza, University of Wisconsin-Madison
11:15-11:25 PRODUCT PRESENTATION 204A
SpaceIQ™ – Powering Next Generation Precision Therapeutics with AI-Driven Spatial Biomarkers
Dusty Majumdar, PredxBio
Single Cell and Spatial Omics
- Single cell transcriptomics technology have been scaled up very nicely over the past ten years
- Spatial informatics field is lacking in innovations
- Can get a terabyte worth of data from analysis of one slide
11:25-11:35 PRODUCT PRESENTATION 204C
11:40-12:35
Transcriptomics and AI in Transforming Precision Diagnosis
Maher Albitar, Genomic Testing Cooperative
Transciptomica and AI:Transforming Precision diagnosis
-The Genomics Testing Coopererative at www.genomictestingcooperative.com
Advantages of transcriptomics
– mutation frequency and allele variant detection now at 80% (higher sensitivity in mutation detection)
– transcriptomics has good detection of chromosomal translocations
– great surrogate for IHC and detect splicing alterations
– can use AI to predict % of PDL1 in tumor cells versus immune cells
– they have developed a software UMAP (uniform manifold approximation and projection) to supervise cluster analysis
– the group has used AI to predict prognosis and survival using transcriptomics data
Marija Balic, UPMC
Andrew Pecora, Hackensack University Medical Center
12:35-1:00
The Impact of Multi-Omics in the Context of the APOLLO-2 Moonshot Program (CME Eligible)
2012pharmaceutical
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