Ford: Case 2 - high risk CDH1+, diffuse gastric cancer. 70yo female. 93yo father healthy. Family history br ca #ASCO15
5:34pm May 29th 2015 via Hootsuite
Ford: Case 1 - 45yo female with MLH1 positive (Lynch) #ASCO15
5:32pm May 29th 2015 via Hootsuite
Ford: These results recently published Kurian '15 http://t.co/GihJqN5tGv #ASCO15
Ford: Participants (36/361) notified; VUS were common (40%) Followup of 1105 pts, 9% had potentially pathogenic mutations #ASCO15
5:31pm May 29th 2015 via Hootsuite
Ford: Looking at a gene panel (42 genes), included high-risk (BRCA); also medium risk genes (BRIP1). 10% had possibly pathogenic mut #ASCO15
5:29pm May 29th 2015 via Hootsuite
Ford: The 'incidentalome': '06 JAMA http://t.co/9gKF8feNfY Then updated in '13 JAMA http://t.co/AlJHn3nPDk #ASCO15
5:27pm May 29th 2015 via Hootsuite
Ford: Incidental means unexpected: directly w/germ-line seq, or indirect via tumor DNA seq #ASCO15
5:24pm May 29th 2015 via Hootsuite
James Ford (Stanford Univ) "Incidental Germ-Line Findings and What to Do about Them" #ASCO15
5:23pm May 29th 2015 via Hootsuite
Hayes:Tumor boards will help ID 'real' mutations from passengers. #ASCO15
5:22pm May 29th 2015 via Hootsuite
Hayes: "There's a ton of work going on sequencing the immune response; many papers will be coming out in coming years" #ASCO15
5:21pm May 29th 2015 via Hootsuite
Hayes: Uses this '12 Pao paper http://t.co/DUgpEr5PPo illustrating the challenge. #ASCO15
Hayes: Vignette: saw MITF in HNSCC (common in melnoma), never seen before. #ASCO15
5:19pm May 29th 2015 via Hootsuite
Hayes: Illustrates a contrast between Nov '13 Foundaiton paper and this one http://t.co/cuRcItoMMJ #ASCO15
5:18pm May 29th 2015 via Hootsuite
Hayes:Medicare's change in reimbursement 3/2013 - state by state, insurer by insurer. Where advocates come in, to make the case #ASCO15
5:15pm May 29th 2015 via Hootsuite
Hayes: Regulatory compliance - the hard part. NGHRI's site: http://t.co/0cxDFdInlL Impact is slowing investment #ASCO15
5:14pm May 29th 2015 via Hootsuite
Hayes: 250ng - 2ug 'many assays'. Normal 'usually helps but not req'd'. 800 pts: % tumor ranges down to 3%. #ASCO15
5:13pm May 29th 2015 via Hootsuite
Hayes: Onto platform: 'typical' is SureSelect, Illumina PE, 500x. "Still you need a homebrew pipeline" #ASCO15
5:12pm May 29th 2015 via Hootsuite
Hayes: Local committee decides - 124 genes chosen. But distinguishing between driver & passengers still needs work #ASCO15
5:11pm May 29th 2015 via Hootsuite
Hayes:What genes to choose? GenomOncology vs COSMIC db's shown. 'You can't outsource it at this time' #ASCO15
5:10pm May 29th 2015 via Hootsuite
Hayes: But error, purity, ploidy, clonality cause issues. At UNC: 1152 var's / 800pt clinical trial: confirmed 96% of them #ASCO15
5:09pm May 29th 2015 via Hootsuite
Hayes: Use of NGS for biomarkers: needs content, compliance, payment and practice. #TCGA looking across 11K tumors at 5% (discovery) #ASCO15
5:08pm May 29th 2015 via Hootsuite
Hayes: One a supressor, other an oncogene. TS's much more complicated (deletions, re-arr., indels, or altered expression) #ASCO15
5:06pm May 29th 2015 via Hootsuite
Hayes: Starts w/melnoma: one gene, single aa change -> one therapy. Very different than everolimus and bladder ca TSC1/2 #ASCO15
5:05pm May 29th 2015 via Hootsuite
David Hayes (UNC-Chapel Hill) "Clinical-Grade Deep Sequencing for Cancer" #ASCO15
5:04pm May 29th 2015 via Hootsuite
McLeod: Reaching for 40% response, not 90%. #ASCO15
5:03pm May 29th 2015 via Hootsuite
McLeod:Toxicity is according to the pt, not the prescriber. Personalized cancer care is around validation & application #ASCO15
5:02pm May 29th 2015 via Hootsuite
McLeod:Longitudinal monitoring: VUS will become known, may come back again to pt with an actionable mutation in the future #ASCO15
5:01pm May 29th 2015 via Hootsuite
McLeod: Practical choices - choosing treatment 'amongst equals'; clinical trial options w/molecular characterization. #ASCO15
5:00pm May 29th 2015 via Hootsuite
McLeod: And reminds to consider 'other genomes' - bacterial, viral, fungal - to understand the pt and guide care from there. #ASCO15
4:58pm May 29th 2015 via Hootsuite
McLeod: Peripheral neuropathy - PGx is the biology. 'If only we had known' - can look at pharmacology revealing disease #ASCO15
4:57pm May 29th 2015 via Hootsuite
McLeod:Pharmacogenomics - lists out 20 variants. HER2-neu, c-kit, ALK etc. w/therapies. '11 NEJM http://t.co/jzefwT0eiJ #ASCO15
4:56pm May 29th 2015 via Hootsuite
McLeod: Many ways to look at pts - not only DNA, but protein, RNA, methylation... precision medicine today will change in future #ASCO15
4:54pm May 29th 2015 via Hootsuite
McLeod: But what about AE? 5th leading cause of death; heavily litigated, many AEs are predictable. #ASCO15
4:53pm May 29th 2015 via Hootsuite
McLeod: Rx costs $: many are $120K/y. 'Probabalistic data is not enough' - increased risk = intervention at a certain poinit #ASCO15
4:52pm May 29th 2015 via Hootsuite
McLeod: The clinical problem - multiple active regimens, variation in response to therapy, unpredictable toxicity #ASCO15
4:50pm May 29th 2015 via Hootsuite
McLeod: "We're forced to use the term 'Precision Medicine' in the US b/c that's what the President calls it" #ASCO15
Howard McLeod (Moffitt Cancer Center) "Using Germ-Line and Somatic Genomic Data for Management of Patients with Cancer" #ASCO15
4:49pm May 29th 2015 via Hootsuite
Chow: Used this figure from '13 Chen http://t.co/phTarvhiN1 to illustrate the immune system / cancer interaction #ASCO15
3:53pm May 29th 2015 via Hootsuite
Chow: Adaptive immune resistance from Tumeh '14 http://t.co/a3X1IlDAE6 Many strategies to convert T-cell poor to T-cell inflamed #ASCO15
3:52pm May 29th 2015 via Hootsuite
Chow: High non-synonymous mutation rate. Mutational landscape from Rizvi Science '14 http://t.co/Jppv5II3mM #ASCO15
3:50pm May 29th 2015 via Hootsuite
Chow: Showed chart from Garon NEJM '15 http://t.co/VVI6w6cMPS of overall survival #ASCO15
3:49pm May 29th 2015 via Hootsuite
Chow: PDL-1 as a biomarker does not have the complete answer; IHC vs progression-free survival. #ASCO15
3:48pm May 29th 2015 via Hootsuite
Chow: Showed difference between responders and non-responders from '14 Nature http://t.co/T9x504UC13 in NSCLC #ASCO15
3:47pm May 29th 2015 via Hootsuite
Chow: Related AE's 53-66%. Grade 3-4 AEs 5-11%; 1-2% pneumonitis. #ASCO15
3:40pm May 29th 2015 via Hootsuite
Chow: ASCO12 - showed first PD-1 checkpoint inhibitor. Topalian '12 NEJM http://t.co/EmN0QBDlga #ASCO15
Laura Quan Man Chow (U Wash) "Considering Immunotherapy in the Adjuvant and Metastatic Setting" #ASCO15
3:38pm May 29th 2015 via Hootsuite
Dy: Molecular Evidence Dev Consortium (MED-C), showed chart comparing to TAPUR. Concl "early data promising" #ASCO15
3:37pm May 29th 2015 via Hootsuite
Dy: NCI-MATCH multiple 'basket' protocol, accrue 1K eligable pts. Ineligable pts - the ASCO Targeted Agent TAPUR registry. #ASCO15
3:36pm May 29th 2015 via Hootsuite
Dy: Showed final chart of 8 genes and frequencies. Showed slide from LUNG-MAP Master protocol. '15 ref http://t.co/IGhGa7zZVE #ASCO15
3:34pm May 29th 2015 via Hootsuite
.@ethan780 Edelman didn't mention by name, but this just came out. http://t.co/df0yArT834
3:31pm May 29th 2015 via Hootsuite in reply to ethan780
