Swanton: Recent Sci Trans Med ref http://t.co/3oeOTZ7LAF Driver mutation were not clonal.. Could be trunk or branch #ASCO15
4:28pm May 30th 2015 via Hootsuite
Swanton: Trunk vs Branch mutations: every tumor has distinct array of clonal and sub-clonal driver events. Drivers can be missed #ASCO15
4:26pm May 30th 2015 via Hootsuite
Swanton: mTOR was active in all regions except 1; L2431P mutation confers constitutive activation. #ASCO15
4:22pm May 30th 2015 via Hootsuite
Swanton:6w of everolimus therapy, status of mTOR pathway across different regions, evidence of differential pathway activity #ASCO15
4:21pm May 30th 2015 via Hootsuite
Swanton: Heterogeneity: between pts, in the tumor, and at the single-cell level. '13 Nature ref http://t.co/kRCRhcTaDn #ASCO15
4:20pm May 30th 2015 via Hootsuite
Swanton: 51/72 FDA drugs approved are targeted/precision. Median improvement: 2.1 months. "Unsustainable" #ASCO15
4:18pm May 30th 2015 via Hootsuite
Charles Swanton (Francis Crick Inst) "Role of Intratumoral Heterogeneity in Understanding Drug Resistance" #ASCO15
4:17pm May 30th 2015 via Hootsuite
Janiszewska:Major challenge of heterogeneity is diagnosis (not included in path reports), treatment. Tracing origin: biomarker dev #ASCO15
4:12pm May 30th 2015 via Hootsuite
Janiszewska: The hope - to predict clonal evolution, to assist therapy '14 Cell Reports http://t.co/UkdN4xNEyn #ASCO15
4:11pm May 30th 2015 via Hootsuite
Janiszewska: Nuc-Seq technology '14 Nature http://t.co/1M1pBPvWev at single-cell level looking at clonal evolution in br ca #ASCO15
4:09pm May 30th 2015 via Hootsuite
Janiszewska: ctDNA not clear yet how reflects tumor heterogeneity. Tracking back evolution via single-cell #ASCO15 http://t.co/h2qSoPDNKB
4:08pm May 30th 2015 via Hootsuite
Janiszewska: Following metastasis to the brain '15 ref http://t.co/UvtU6ZUCaM Can follow evolution via CTCs, ctDNA #ASCO15
4:06pm May 30th 2015 via Hootsuite
Janiszewska: DCIS to IDC progression - one of a list of many ref's '13 Genome Res http://t.co/UnqXXtiGgz #ASCO15
4:03pm May 30th 2015 via Hootsuite
Janiszewska: Progression from DC in-situ, to invasive, to metastatic in br ca. Aim is to predict, prevent. Monitor during treatment #ASCO15
4:02pm May 30th 2015 via Hootsuite
Janiszewska:Evolution driven by diversity, selection & replication. Not linear nor gradual; parallel and dynamic interactions. #ASCO15
4:00pm May 30th 2015 via Hootsuite
Michalina Janiszewska (Dana Farber Cancer Inst) "Molecular Evolution of Human Breast Tumors" #ASCO15
3:59pm May 30th 2015 via Hootsuite
Porter:The only goal - value for the pt = health outcomes that matter to the pt divided by cost of delivery of those outcomes #ASCO15
10:59am May 30th 2015 via Hootsuite
Porter: 'We are starting to see a clear path forward'- scary b/c it is a different way of doing things, and starting to show results #ASCO15
10:55am May 30th 2015 via Hootsuite
Porter: 'One of the great unsolved problems' - expensive technology, extraordinary reimbursement pressures. Many ideas tried... #ASCO15
10:53am May 30th 2015 via Hootsuite
Michael Porter (Harvard Business School) "Value-Based Health Care Delivery: the Agenda for Oncology" #ASCO15
10:52am May 30th 2015 via Hootsuite
Chanock:A2:For BRCA, is helpful. But for others, the numbers will bear this out (in the future) #ASCO15
10:25am May 30th 2015 via Hootsuite
Parsons:Q:What about a young person w/adult-onset ca suscept incidental finding? A: Return of results isn't controversial to family #ASCO15
10:24am May 30th 2015 via Hootsuite
Chanock:Q:Does proteomics add value? A:In an earlier stage, may not be applicable to large numbers #ASCO15
10:18am May 30th 2015 via Hootsuite
Chanock: Uses a Woodrow Wilson quote 'I not only use all the brains I have, but all that I can borrow' as a plea for data sharing #ASCO15
10:16am May 30th 2015 via Hootsuite
Chanock:Also - 'community standards for sequencing metrics' #ASCO15
10:14am May 30th 2015 via Hootsuite
Chanock: 'We need to have an efficient transition plan for moving from discovery to clinic'. Larger network for studies. #ASCO15
Chanock:Osteosarcoma and TP53 germline mutations - remaining questions about scope of testing, how to counsel.. #ASCO15
10:13am May 30th 2015 via Hootsuite
Chanock: Dangers of using 'association' in counseling, as it can affect choice of body-altering (prophylactic) surgery #ASCO15
10:11am May 30th 2015 via Hootsuite
Chanock: Of 115 predisp genes - >50% are COSMIC 'drivers'; less than 1/3 are recognized by ACMG, triggering counseling #ASCO15
10:09am May 30th 2015 via Hootsuite
Chanock: Shows effect size x allele freq chart (Manolio) 115 genes are very rare. BRCA world - incomplete penetrance (~65% by 70yo) #ASCO15
10:08am May 30th 2015 via Hootsuite
Chanock: Need for incidental germline findings, tumor mutationis, need to both be available. #ASCO15
10:07am May 30th 2015 via Hootsuite
Chanock: A cancer knowledge system - pilot studies up in 2016; ID low-freq drivers. Also needs normal tissue seq #ASCO15
10:06am May 30th 2015 via Hootsuite
Chanock: A central question of numbers - storing data and sharing it is a critical need. N of 1 'has value but is limited' #ASCO15
10:04am May 30th 2015 via Hootsuite
Chanock: Proposed precision medicine initiative - Pediatric MATCH trial, knowledge system to support, and preclinical models #ASCO15
10:03am May 30th 2015 via Hootsuite
Chanock: Within the last year: Lung-MAP, ALCHEMIST, IMPACT, Exceptional Responders initiatives #ASCO15
10:02am May 30th 2015 via Hootsuite
Chanock: Precision Medicine - NCI already devotes 10% of its budget to this effort. FY16 budget $70M for this. #ASCO15
Chanock: (Oops - here's the 2014 TCGA Nature ref http://t.co/ozWwpDn0uT ) #ASCO15
10:01am May 30th 2015 via Hootsuite
Chanock: Lung adeno ca - 25% no appreciable driver, 32% KRAS, long tail of target-able mutations (TCGA '14 ref) #ASCO15
9:59am May 30th 2015 via Hootsuite
Chanock: TCGA and mutational landscape - which are real? Very small #'s, freq doesn't equal importance; need to be careful #ASCO15
9:58am May 30th 2015 via Hootsuite
Chanock: In his genotyping lab, he always sees errors. Some 500K samples; important for the CLIA setting. Errors as high as 2% (!) #ASCO15
9:56am May 30th 2015 via Hootsuite
Chanock:Clinical test in CLIA; research tests are performed 'all over'. No clear chain of custody, vague and indeterminate timeline #ASCO15
9:55am May 30th 2015 via Hootsuite
Chanock: Germline: >115 cancer syndrome genes; >25 moderate penetrant; >475 GWAS loci. #ASCO15
9:54am May 30th 2015 via Hootsuite
Chanock: Four spaces - germline/somatics; another axis is discovery/clinically actionable. 98% of ca genomics has been discovery #ASCO15
9:51am May 30th 2015 via Hootsuite
Stephen Chanock (NCI) "Risks and Benefits of Real-Time Molecular Profiling" #ASCO15
9:49am May 30th 2015 via Hootsuite
Carroll:Impact will be best assessed where 'therapy specified at the outset' NCI-MATCH 'will be key' #ASCO15
9:48am May 30th 2015 via Hootsuite
Carroll: Mutation outgrowth 'correlates with therapy. T ALL and B ALL, very different cancers, have same pathway. #ASCO15
9:47am May 30th 2015 via Hootsuite
Carroll: Mutation in NT5C2 confer resistance to purine analogues. #ASCO15 '13 ref http://t.co/E8mB6UYDE6
9:46am May 30th 2015 via Hootsuite
Carroll:Clonal evolution in ALL Ma '15 ref http://t.co/S1lBE11fjh NT5C2 relapse-specific mutation #ASCO15
9:44am May 30th 2015 via Hootsuite
Carroll: Repeat biopsies 'essential' due to branch chain model of evolution upon relapse. Clones may be synergistic, or competitive #ASCO15
9:42am May 30th 2015 via Hootsuite
Carroll: Dasatinib - CRLF2 low, likely fusion. CRLF2 high, Ruxolitinib. (Complex flowchart) #ASCO15
9:40am May 30th 2015 via Hootsuite
