Sninsky: Procedures: 2.5K heart/y, 16.9K liver/y. Pt pool: 25K heart, 180K kidney. #TRICON '11 PNAS https://t.co/FcjZBpiO8D
12:55pm March 11th 2016 via Hootsuite
Sninsky: Post-xplant: est 90% is over-suppressed. Increased risk of infection, cancer, diabetes. 10x-50x greater ca risk #TRICON
12:53pm March 11th 2016 via Hootsuite
Sninsky: Unmet need for xplant pts: life-long immuno-supp Rx; highest-cost pt in the system. Mean survi: 12y heart, 10y kidney #TRICON
12:52pm March 11th 2016 via Hootsuite
John Sninsky (CareDx) Measuring donor-derived cell-free DNA in organ transplant recipients as a dynamic biomarker of rejection #TRICON
12:51pm March 11th 2016 via Hootsuite
Hoon: "Getting a marker approved is much harder in the past 5y" Yesterday a person said >$100M for a (companion) diagnostic #TRICON
12:49pm March 11th 2016 via Hootsuite
Zhao: You may get more cfDNA from serum but ctDNA percentage is lower, points to PGDx poster. #TRICON
12:47pm March 11th 2016 via Hootsuite
Hoon: 900x cov. enough? A:Yes, they've shown single-molecule, but a cost issue for deeper coverage #TRICON
12:44pm March 11th 2016 via Hootsuite
Hoon: A2: Impt to understand the natural disease, and what the clinician needs. LDH std for melanoma for 20y #TRICON
12:42pm March 11th 2016 via Hootsuite
Q:Lymph node a bellweather? Hoon:Showed you can have no lymph met but still distant metastasis. Aggressive screening:changed br ca #TRICON
12:41pm March 11th 2016 via Hootsuite
Hoon: Shows clinical report with graphic of a 'response map' over time, as well as long list (5-7) of Lung ca studies #TRICON
12:36pm March 11th 2016 via Hootsuite
Hoon: Post-surgical resection mon. is impt, esp melanoma. 75% of death within 5y. Clinicians need to know for NED in clinical mgmt #TRICON
12:34pm March 11th 2016 via Hootsuite
Hoon: Shows several complex examples cp w/LDH (for Stg III/IV melanoma) and correlation with ctDNA #TRICON
12:28pm March 11th 2016 via Hootsuite
Hoon: All smpls x 54 genes, shows drop from pre- to post-op; spike of ctDNA at Stg IV recurr; across 8 mutations (PIK3CA, EGFR etc) #TRICON
12:25pm March 11th 2016 via Hootsuite
Hoon: MSLT study was 2200 melanoma pts, 15y followup w/blood every year. No treatment, Stg III w/o treatment, until Stg IV recurr #TRICON
12:23pm March 11th 2016 via Hootsuite
Hoon: From distant organ, to secondary organ is another rise in cfDNA (say to brain). #TRICON
12:21pm March 11th 2016 via Hootsuite
Hoon: Shows cfDNA outcomes in sentinel lymph node+ pts: From primary to lymph, cfDNA and CTC to distant organ, cfDNA dormancy #TRICON
12:20pm March 11th 2016 via Hootsuite
Hoon:Four 9's specficity.'15 PLoS ref https://t.co/GN8LYK8CPK Early melanoma tumor/cfDNA Stg IV, from 0.2% - 23% #TRICON
12:18pm March 11th 2016 via Hootsuite
Hoon: 70 genes, 16 amplfications, 7 fusions. 2w TAT, 2x10mL, automated. >900x coveage. Shows sensitivity down to 0.1% #TRICON
12:16pm March 11th 2016 via Hootsuite
Hoon:Did 5K pts last year 'with 70% reimbursement'. Their '15 Guardant360 panel: cover amplifications and fusions and indels #TRICON
12:14pm March 11th 2016 via Hootsuite
Hoon: Shows noise for most accurate NGS, labeled 'Analog'. Shows digital, suppressing background noise. #TRICON
12:13pm March 11th 2016 via Hootsuite
Hoon: Why SNV/CNV focus: targeted therapy. Single-molecule sequencing, proprietary sample-prep; also 'digital bioinformaticsTM' #TRICON
12:10pm March 11th 2016 via Hootsuite
Hoon: Recent work: reimbursement. Disclosure: Guardant Health. '13 fig https://t.co/wB7SF80KXH Many forms: MS (LOH), SNV, CNV, CpG #TRICON
12:08pm March 11th 2016 via Hootsuite
Hoon: (NB - @DaleYuzuki spent 6 years in Dave Hoon's lab at the John Wayne Cancer Inst Santa Monica. Good times.) #TRICON
12:05pm March 11th 2016 via Hootsuite
Dave S.B. Hoon (John Wayne Cancer Inst) Multipanel massive parallel sequencing cfDNA in monitoring cutaneous melanoma progression #TRICON
Q:Space for ddPCR vs genomics for ctDNA? Forshew: Info on clonality, a method of tracking, but a balance of methods for cost #TRICON
12:03pm March 11th 2016 via Hootsuite
Q:Adoption process in the UK? Paid for? Forshew: BD person spoke at #TRICON yesterday. Need to convince still exists.
12:02pm March 11th 2016 via Hootsuite
Forshew: Concludes with many ack's, and 'Inivata is hiring! Email us!' "If you are interested in moving to the UK" (disclaimer) #TRICON
12:01pm March 11th 2016 via Hootsuite
Forshew: Distribution of AF fractions - 5% at 0-0.1%; 30% at 0.1-0.5% 15% at 0.5-1%. (Thus: 50% of these samples <1% ctDNA) #TRICON
12:00pm March 11th 2016 via Hootsuite
Forshew: Stable individ's level amts of ctDNA; for others drastic decreases in ctDNA. One case: AZD9291 exp'l trtmt response #TRICON
11:59am March 11th 2016 via Hootsuite
Forshew: But for the relatively few, good concordance when enough biospy tissue was available #TRICON
11:57am March 11th 2016 via Hootsuite
Forshew: 20 NSCLC, 18 naive, 2 post-Rx. 10 pts 2nd sample 21d post-chemo. 19/20 detectable ctDNA. But majority: insuff tissue to cp #TRICON
Forshew: Will present validation data at Lawson et al #AACR16 ERBB2: amplified data shown #TRICON
11:54am March 11th 2016 via Hootsuite
Forshew: Amplicon-based TAm-Seq, balance of 0.1% detection and coverage. FGFR1/2, MET, MYC are CNVs on panel. Tile NRA, PTEN, others #TRICON
Forshew: Murtaza (speaking later) did exome-wide for ctDNA. '14 started inivata w/ 6, now team of 20, closed $45M Series A #TRICON
11:52am March 11th 2016 via Hootsuite
Forshew: From '12 STM, looked at debulking ovarian surgery, detection of TP43 and EGFR mutations, collected at dx, then relapse #TRICON
11:51am March 11th 2016 via Hootsuite
Forshew: But via dPCR, not detecting mutations that evolve. Felt NGS was the method to use #TRICON
11:48am March 11th 2016 via Hootsuite
Forshew: br ca, ctDNA det in 69% of pts pre-treatment. DFS clear difference, predict relapse '15 ref https://t.co/Ayv4hNHtIw #TRICON
11:47am March 11th 2016 via Hootsuite
Forshew: Graph showed relation between ctDNA and CA125 decrease over time during treatment. #TRICON '13 NEJM https://t.co/oDVAGH3wLU
11:45am March 11th 2016 via Hootsuite
Forshew: HGSOV (high-grade serous ovarian ca) - found ctDNA cp to CA125, at first w/digital PCR, 37/41 detected, followed over time #TRICON
11:43am March 11th 2016 via Hootsuite
Forshew: From '09: Rosenfeld lab founded at CRUK; '10-12 TAm-Seq dev '12 ref https://t.co/zoiDXac7Gp #TRICON
11:42am March 11th 2016 via Hootsuite
Tim Forshew (Inivata) High sensitivity NGS analysis of ctDNA: applications to NSCLC and beyond #TRICON
11:40am March 11th 2016 via Hootsuite
Q: Use of RCA enzyme is done at RT? A:Have spent a lot of time on that part (proprietary). #TRICON
11:36am March 11th 2016 via Hootsuite
Q:If the nucleosomes are phased? A:cfDNA carries mutation but collision chance is low #TRICON
11:34am March 11th 2016 via Hootsuite
Q: Can measure absolute copies? Zhao: No barcodes, able to distinguish by the ends of the cfDNA pieces #TRICON
11:33am March 11th 2016 via Hootsuite
Zhao: If assay is too sensitive, everyone would be diagnosed w/cancer; a baseline needs establishing for effective screening #TRICON
11:26am March 11th 2016 via Hootsuite
Zhao: Screening: low AF is a problem. Shows as low a 0.04% w/# of unique copies (1400-4600); mut's range from 2-11 #TRICON
11:24am March 11th 2016 via Hootsuite
Zhao:Prognosis: early Stg I/II Panc Ca, ctDNA before surgery (Changhai Hosp). OS better for ctDNA neg. PFS diff not as clear #TRICON
11:23am March 11th 2016 via Hootsuite
At #TRICON, Groups Detail NGS-Based Strategies to Detect ctDNA Mutations at Ever Lower Frequencies | GenomeWeb ($) https://t.co/ADKuW5sJYP
11:21am March 11th 2016 via Hootsuite
Zhao:Plasma was 3y old, n=46. Another study, Dr Shen Xinhua Hosp retrospective late-stage mCRC 2yo plasma, n=3, time-course utility #TRICON
Zhao: AccuAct assay: w/Dr Wang of Beijing Meitan Hosp, correlate tissue and ctDNA concordance in late-stage NSCLC in archived plasma #TRICON
11:18am March 11th 2016 via Hootsuite
