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Track 6 Systems Pharmacology: Pathways to Patient Response @ BioIT World, April 29 – May 1, 2014 Seaport World Trade Center, Boston, MA

Reporter: Aviva Lev-Ari, PhD, RN

April 30, 2014

Modeling: Novel Tools

10:50 Chairperson’s Remarks

Avi Ma’ayan, Ph.D., Associate Professor, Pharmacology and Systems

Therapeutics, Icahn School of Medicine at Mount Sinai

11:00 The Human Avatar: Quantitative Systems Pharmacology to Support Physician Decision Making in Neurology and Psychiatry

Hugo Geerts, Ph.D., MBA, BA, CSO, In Silico Biosciences;

Adjunct Associate Professor, Perelman School of Medicine, University of Pennsylvania

CNS Quantitative Systems Pharmacology uses computer-based mechanistic modeling integrating brain network neurophysiology, functional imaging of

genetics, pharmacology of drug-receptor interactions and parameterization with clinical data. A patient model (“human avatar”) can be developed

accounting for polypharmacy and life history of traumatic events to help identify optimal treatments.

 

11:30 VisANT: An Integrative Network Platform to Connect Genes, Drugs, Diseases and Therapies

Zhenjun Hu, Ph.D., Research Associate Professor, Center for Advanced Genomic Technology,

Bioinformatics Program, Boston University

With the rapid accumulation of our knowledge on diseases, disease-related genes and drug targets, network-based analysis plays an increasingly

important role in systems biology, systems pharmacology and translational science. The new release of VisANT aims to provide new functions to facilitate

the convenient network analysis of diseases, therapies, genes and drugs.

12:00 pm Selected Oral Poster Presentation: Individualized PK/PD Biosimulations for Precision Drug Dosing: Diabetes Mellitus

Clyde Phelix, Ph.D., Associate Professor, Biology,

University of Texas San Antonio

Individualized biosimulations offer many advantages to precision medicine. Using one’s transcriptome to determine parameters of kinetic models of metabolism reanimates that individual for in silico testing. The Transcriptome-To-Metabolome™ Model is multiorgan and multicompartmental, including over 30 primary and secondary metabolic pathways and transport processes. Thus pharmacokinetics/pharmacodynamics studies can be performed in silico before treating each patient.

12:40 Luncheon Presentations (Sponsorship Opportunities Available) or Lunch on Your Own

Modeling: Cancer

1:50 Chairperson’s Remarks

Hugo Geerts, Ph.D., MBA, BA, CSO, In Silico Biosciences; Adjunct Associate Professor, Perelman School of Medicine, University of Pennsylvania

In REAL TIME

»»1:55 FEATURED PRESENTATION

Identifying Drug Targets from Drug-Induced Changes in Genome-Wide mRNA Expression

Avi Ma’ayan, Ph.D., Associate Professor, Pharmacology and Systems Therapeutics, Icahn School of Medicine at Mount Sinai

We collected and organized publicly available genome-wide gene expression data where hundreds of drugs were used to treat mammalian cells and changes in expression were compared to a control. We then developed computational methods that try to find the drug targets from the expression changes. We show that different steps in the analysis can contribute to approaching the right answer.

In REAL TIME

System biology and drug related by phynotypes, drugs causes diseasespatient and side effects

Networs,

Gene-set Libraries stored in Gene Matrix Transpose(GMT) files, KEGG Example

Drug-set Libraries

Drug-Drug similarity data, SIDER 2 Side Effect Resource, FDA adverse effect Report data

Connactivity Map: Broad  Institute, L1000 cell lines microarray, different  drug dose, DRUG effect on GENES

  • develop new compondts,
  • measure toxicity

LINC-L1000 data overview, Drug-drug similarity structure, connversion

for Vector side effect

LINCS Canvas Browser

Cell-Line/Drug Browser

New method for clustering patient by outcomes, survival analysis

http://www/maayanlab.net/LINCS/LCB/

Drug interact with target drug vs transcription factors, over expression

Over expression of transcription factors vs knock out for validation

2:25 Infrastructure for Comparison of Systematically Generated Cancer Networks vs. Literature Models

Dexter Pratt, Project Director,

NDEx, Cytoscape Consortium

Cancer subtype genetic networks can be generated by systematic analysis of patient somatic mutation data. Comparison to existing models of cancer

mechanisms is an important step in investigating these data-derived models. Recent work on Network Based Stratification (NBS) at the Ideker Lab will be

described along with tools for network comparison under development in the NDEx project.

In REAL TIME

Network based classification, unsupervised methoods

Ovarian cancer- sparse mutations, no two patients share same mutation, clustering by expression profile – can be cause, gene – gene interaction, smooth knowlede,

Reference networks, Common Entity identification system used, started at UCSD. overlap of curated PATHWAYS, query, neighborhoods in the reference network,

Using mapping tables to mapp identifiers for entity correspondence

Complex Reference Networks N:1 and 1:N

Transcriptionalcontrol motif, extract motifs mapp data to motifs, concordence,  and other metrics to be computed fromreferenced data,

Boundaries of Pathways – Reaction chain,  Differentially expressed genes –>> enzymes –>>> reactions  (differentilly regulated) –>> smaoll molecules

CONCLUTIONS

Cliniccal relevance, hypothesis motifs and interactions.

MAY 1, 2014

Modeling: Drug/Dose Response

1:55 Chairperson’s Remarks

Birgit Schoeberl, Ph.D., Vice President, Research, Merrimack Pharmaceuticals

»»2:00 FEATURED PRESENTATION

Systems Approaches to Risk Assessment

Lawrence J. Lesko, Ph.D., FCP, Clinical Professor and Director, Center for Pharmacometrics and Systems Pharmacology, University of Florida

“Idiosyncratic” adverse drug events (ADEs) are a substantial societal burden in terms of morbidity, mortality and healthcare costs. Predicting who

will suffer ADEs from what medications is extremely difficult with current observational or surveillance approaches. A new mechanistic approach to

drug safety science is sorely needed. Systems approaches may address this unmet medical need.

2:30 Pharmacodynamic Characterization of Compounds in Drug Discovery

Rui-Ru Ji, Ph.D., Principal Scientist, Genomics, Bristol-Myers Squibb

The transcriptome reacts in a dose-dependent manner to compound treatment. We will present methodology and will discuss multiple applications of dose

response profiling of the whole transcriptome.

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PLENARY KEYNOTE PRESENTATIONS: TUESDAY, APRIL 29 | 4:00 – 5:00 PM @ BioIT World, April 29 – May 1, 2014 Seaport World Trade Center, Boston, MA

 

Reporter: Aviva Lev-Ari, PhD, RN

 

PLENARY KEYNOTE PRESENTATIONS:

TUESDAY, APRIL 29 | 4:00 – 5:00 PM

Keynote Introduction: Sponsored by Dave Wilson, Senior Director, Business Development Manager, Global Channels, Hitachi Data Systems

John Quackenbush, Ph.D.

CEO, GenoSpace; Professor, Dana-Farber

Cancer Institute and Harvard School of Public Health

John Quackenbush received his Ph.D. in 1990 in theoretical physics from UCLA working on string theory models. Following two years as a postdoctoral fellow in physics, Dr. Quackenbush applied for and received a Special Emphasis Research Career Award from the National Center for Human Genome Research to work on the Human Genome Project. He spent two years at the Salk Institute and two years at Stanford University working at the interface of genomics and computational biology. In 1997 he joined the faculty of The Institute for Genomic Research (TIGR) where his focus began to shift to understanding what was encoded within the human genome. Since joining the faculties of the Dana-Farber Cancer Institute and the Harvard School of Public Health in 2005, his work has focused on decoding and modeling the networks of interacting genes that drive disease. In 2011 he and partner Mick Correll launched GenoSpace to facilitate genomic data analysis and interpretation, focused on accelerating research and delivering relevant and actionable solutions for personalized medicine.

IN REAL TIME FROM THE AMPHITHEATER of World BioIT2014

Twitter

#BioIT14

2900 attendees 140 exhibitor, 250 Speakers, Best of Show Awart, Best Practices Award, Franklin Award, Memorial to Pat McGovern ex-CEO and Chairman of IDG and launcher of BioIT, McGovern Institute for Brain Research @MIT his gift $350 million, [Broad’s gift to MIT was $650million]

Hitachi Data Perspective

Cloud and Aanlytics

John Quackenbush about Precision Medicine

Desire to use an information ecosystem for mediicine

The DRIVER is DATA – access t data Data that drives innovations in BioMedical

IT

  • Cloud Computing data, information and STORAGE of Data, data access, integration,
  • iPhone – applications for needs,

Bio – anniversary of DNA discovery structure in 1953

Genome Sequence – Transforming Medicine: Big Data: Volume, Velocity, Variety

Genomic Medicine – data for interpretation of Symptoms: diet, exercise

Cost of generation of data drops clinical relevance of data – sequencing now $1000 pay with credit card

Cost of the Analysis – $100,000 – Research number the genes translational, identify biomarkers to better achieve efficacy in segments of the population.

Diagnosis – Clinical Medicine

Reimbursement – few $ to identify VARIANCE relevant to treat disease

Cloud – secure the infrastructure – same dat looked by different parties to answer different questions.

GenoSpace for Research – N= many patients

GenoSpace for Clinical Care – N=1

GenoSpace for Patient Community – N=many individual patients

Patient CONSENT

  • Secure storage data
  • analytics and visualization
  • diverse data
  • share dat securely

data in transit to be secure,  consumption of data

R&D Context

1000 Patients

50 Clinical site

large complex data

MMRF’s COMMPASS Study @Dana Farber – Multiple Myeloma Research Foundation

PORTAL design – to make data analysis of Cohort of Patioets, attribute analyzer, tools to find properties of cohort, compare across cohorts

Data analysis made easy – Precision Medicine based on Prediction

Population level data

end stage treatment

clincal trial

Translational Research – Pharma targets patients 

MMRF – gateway to the Community, interface for Patients to provide information during the course of Treatment, PATIENTS share, 1000 patients signed up to share data

  • Patient Reported outcomes
  • data integration
  • clinical trial recruitment
  • biomarker discovery

HOW to deliver data to POINT of CARE: Cancer more data Clinical (Pathology/Lab)

BioPoetry: Story what the data analysis MEANS

CURATION OF DATA – GenoSpace – for Clinical Labs

  • Pathology Group: Sequencing
  • Application development for REPORTS: FullView – meta data GEnoSpace 
  • Look at the assay for standard of Care
  • PDF format to scan and place in EMR, language suggestive,
  • MD’s Portal, giving access to Patients to add data

 

Thomson Reuter – Annotate

An OS for Precision Medicin

Genomics and integration with Clinical data

how to create system for all parties involved. Use of data for multiple needs that overlap

Information management – patient at the center

Precision Medicine is the FUTURE – Digital Architects for Precision Mediicne

 

 

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Improved Results for Treatment of Persistent type 2 Endoleak after Endovascular Aneurysm Repair: Onyx Glue Embolization

Writer, Curator: Larry H Bernstein, MD, FCAP

and

Curator: Aviva Lev-Ari, PhD, RN 

 

 

This report is an evaluation of onyx glue use in endovascular aneurysm repair. Onyx® is a non-adhesive liquid embolic agent used for the pre-surgical embolization of brain Arteriovenous malformations (bAVM).
Onyx is comprised of EVOH (ethylene vinyl alcohol) copolymer dissolved in DMSO (dimethyl sulfoxide), and suspended micronized tantalum powder to provide contrast for visualization under fluoroscopy.
A DMSO compatible delivery micro catheter that is indicated for use in the neuro vasculature (e.g. Marathon™, Rebar® or UltraFlow™ HPC catheters) is used to access the embolization site.
Onyx is available in two product formulations, Onyx 18 (6% EVOH) and Onyx 34 (8% EVOH).
ONYX glue

Improved results using Onyx glue for the treatment of persistent type 2 endoleak after endovascular aneurysm repair. 

Abularrage CJ, Patel VI, Conrad MF, Schneider EB, Cambria RP, Kwolek CJ
Division of Vascular and Endovascular Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Mass 02114, USA.
J Vasc Surg. 2012 Sep;56(3):630-6.  http://dx.doi.org/10.1016/j.jvs.2012.02.038.  Epub 2012 May 8.
Persistent type 2 (PT2) endoleaks (present ≥ 6 months) after endovascular aneurysm repair are associated with adverse outcomes, and
  • selective secondary intervention is indicated in those patients with an expanding aneurysm sac.

This study evaluated the outcomes of secondary intervention for PT2.

From 1999 to 2007, 136 patients who underwent endovascular aneurysm repair developed PT2 and comprised the study cohort. Primary end points included
  • PT2 resolution (secondary interventional success) and
  • survival
 both  were evaluated using multiple logistic regression and Kaplan-Meier analyses
Fifty-one patients underwent a total of 68 secondary interventions for PT2 with expanding aneurysm sacs
  • with a median postsecondary interventional follow-up of 13.7 months.

Secondary interventions included

  • 20 inferior mesenteric artery coil embolizations,
  • 17 Onyx glue embolizations,
  • 11 aneurysm sac coil embolizations,
  • 10 non-Onyx glue embolizations,
  • 7 lumbar artery coil embolizations,
  • 2 open lumbar ligations, and 1 graft explant.
The overall secondary interventional success rate was 43% (29 of 68). Onyx glue embolization was associated with
  • a greater success rate when used as the initial secondary intervention (odds ratio, 59.61; 95% confidence interval, 4.78-742.73; P < .001). 
There was no difference in success between the different techniques when multiple secondary interventions were required. Five-year survival was 72% ± 0.08% and
  • was unrelated to any of the secondary interventional techniques.
Secondary intervention for PT2 is associated with success in less than half of all cases. Onyx glue embolization was associated with greater long-term success
  • when used as the initial secondary intervention.
Competition in the Ecosystem of Medical Devices in Cardiac and Vascular Repair: Heart Valves, Stents, Catheterization Tools and Kits for Open Heart and Minimally Invasive Surgery (MIS)  (Aviva Lev-Ari)
Vascular Repair: Stents and Biologically Active Implants (larryhbern)
Drug Eluting Stents: On MIT’s Edelman Lab’s Contributions to Vascular Biology and its Pioneering Research on DES  (larryhbern)
Coronary Artery Disease – Medical Devices Solutions: From First-In-Man Stent Implantation, via Medical Ethical Dilemmas to Drug Eluting Stents  (Aviva Lev-Ari)
Trans-apical Transcatheter Aortic Valve Replacement in a Patient with Severe and Complex Left Main Coronary Artery Disease (LMCAD) (larryhbern)
Transcatheter Aortic Valve Replacement (TAVR): Postdilatation to Reduce Paravalvular Regurgitation During TAVR with a Balloon-expandable Valve  (larryhbern)
Svelte Medical Systems’ Drug-Eluting Stent: 0% Clinically-Driven Events Through 12-Months in First-In-Man Study  (Aviva Lev-Ari)
Acute and Chronic Myocardial Infarction: Quantification of Myocardial Perfusion Viability – FDG-PET/MRI vs. MRI or PET alone  (Justin Pearlman, Aviva Lev-Ari)
Biomaterials Technology: Models of Tissue Engineering for Reperfusion and Implantable Devices for Revascularization (larryhbern)
Revascularization: PCI, Prior History of PCI vs CABG  (A Lev-Ari)
The ACUITY-PCI score: Will it Replace Four Established Risk Scores — TIMI, GRACE, SYNTAX, and Clinical SYNTAX  (A Lev-Ari)
Absorb™ Bioresorbable Vascular Scaffold: An International Launch by Abbott Laboratories (Aviva Lev-Ari)
Carotid Stenting: Vascular surgeons have pointed to more minor strokes in the stenting group and cardiologists to more myocardial infarctions in the CEA cohort. (A Lev-Ari)
Endovascular repair of cerebral aneurysm.

Endovascular repair of cerebral aneurysm. (Photo credit: Wikipedia)

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