Linderman: For initial Dx - only if tissue unavailable. Monitoring is 'very exciting, very unproven', cannot recommend at present #AMP2016
11:08am November 12th 2016 via Twitter Web Client
Linderman: Clinical utility for ctDNA has 'lots of buzz, evolving'. CTC not ready. 3 contexts: Dx, monitoring, acquired resist. #AMP2016
11:07am November 12th 2016 via Twitter Web Client
Linderman: ASCO poster: https://t.co/MXcOOHbiIN Relapse tests for T790M have to be sensitive; thus lowered to 4% #AMP2016
11:06am November 12th 2016 via Twitter Web Client
Linderman: Shows poster from ASCO '16 - plasma, tissue and urine ID unique and overlapping T790M #AMP2016
11:04am November 12th 2016 via Twitter Web Client
Linderman: Showing cfDNA as an option to biopsy. For EGFR, shows figure from Guardant Health over progression and time of Rx #AMP2016
11:03am November 12th 2016 via Twitter Web Client
Linderman: Illustrates heterogeneity in response to TKI, emergence of clones. Waterfall plot '16 ref https://t.co/SpojdsIWfz #AMP2016
11:02am November 12th 2016 via Twitter Web Client
Linderman: Shows 5w response w/scans, clearing in liver and bone. Heavily pre-treated, still sensitivity was retained #AMP2016
11:00am November 12th 2016 via Twitter Web Client
Linderman: Progressed, put on Doxataxel, did cfDNA test w/T790 mut, Osimertinib, very good response. #AMP2016
Eric Bernicker (Houston Methodist, TX) looking at Case Study - 55yo male, metastatic adeno. Chemo, no EGFR test, erlotinib. 18mos #AMP2016
10:59am November 12th 2016 via Twitter Web Client
Linderman: Now new genes for squamous, or small cell. NGS acceptable alt to multiple single-gene tests. PD1/PDL1 not now #AMP2016
10:58am November 12th 2016 via Twitter Web Client
Linderman: New gene, std of care, is ROS1; IHC acceptable for ALK, ROS1, not EGFR. T790M sens. now down to 4% tumor cells #AMP2016
10:57am November 12th 2016 via Twitter Web Client
Linderman: Also Sensitivity LOD cutoff is 20% cancer cells (before was 50%) Getting smaller biopsies #AMP2016
10:56am November 12th 2016 via Twitter Web Client
Linderman: Since '13: Syntax, strength augmentation, equality for all cytology specimens, TAT to recut is 3d vs 24h before #AMP2016
10:55am November 12th 2016 via Twitter Web Client
Linderman: 3y later: CAP, IASLC, and AMP. List of rec's is long. Draft will be joint pub in JMD, Archives and JTO. 900 comments #AMP2016
10:54am November 12th 2016 via Twitter Web Client
Neil Linderman (Brigham and Women's Hosp MA): Revised guidelines for clinical molecular Dx in lung cancer #AMP2016
10:53am November 12th 2016 via Twitter Web Client
Siu: Expects Pt-derived xenografts an emerging effort. Datasharing: an impt goal, but who pays for it? https://t.co/8TqPi9FeVZ #AMP2016
8:53am November 12th 2016 via Twitter Web Client
Siu: CAPTUR study model, their Canadian effort. Start w/single agents, want to move to combination Rx. But complex, future #AMP2016
8:50am November 12th 2016 via Twitter Web Client
Siu: TAPUR has a goal to learn 'from the real world practice of prescribing targeted therapies' DRUP similar Netherlands #AMP2016
8:49am November 12th 2016 via Twitter Web Client
Siu: To increase the numbers need global screening. Table of large #'s needed '13 ref https://t.co/sOAlEPNaBB #AMP2016
8:47am November 12th 2016 via Twitter Web Client
Siu: Reviews data from SHIVA trial from table '15 Lancet Oncol ref https://t.co/U6rtOEH2Ra #AMP2016
8:45am November 12th 2016 via Twitter Web Client
Siu: Their group, shows table of enrollment '16 ref https://t.co/dZ7cpmc7o0 Match rates between genotype and Rx only 1-5% #AMP2016
8:43am November 12th 2016 via Twitter Web Client
Siu: Basket trial for BRAF V600 non-melanoma muts NEJM '15 https://t.co/sDagbtnMy2 #AMP2016
8:42am November 12th 2016 via Twitter Web Client
Siu: Con's: May not get access to 'best-in-class' drugs. A few pharmas may contribute, but not all. Also change to std of care #AMP2016
8:40am November 12th 2016 via Twitter Web Client
Siu: Also link clinical and genomic data for big data learning. Con's: Only common tumor types, only signal finding #AMP2016
8:39am November 12th 2016 via Twitter Web Client
Siu: Basket trials listed, such as MATCH, IMPACT. Table of pro's: multiple questions, int'l engagement for rare or uncommon muts #AMP2016
8:38am November 12th 2016 via Twitter Web Client
Siu: Basket and Umbrella trials are a direct result of matching pts to molecular profiles '15 review https://t.co/bUhI8yVgkl #AMP2016
8:37am November 12th 2016 via Twitter Web Client
Siu: As part of @GA4GH they surveyed (n=59, worldwide ex-China and ex-India) to determine hurdles to testing, datasharing #AMP2016
8:34am November 12th 2016 via Twitter Web Client
Siu: Many institutes, hospitals, companies doing testing. More clinical trial data; Datasharing initiatives CancerLinQ, GENIE, CCE #AMP2016
8:32am November 12th 2016 via Twitter Web Client
Siu: Shows report from Foundation Med; potential clinical trials for off-label, and how it may hard for community hosp physicians #AMP2016
8:29am November 12th 2016 via Twitter Web Client
Siu: Points to fig from this recent Genome Med ref https://t.co/njqa8tj1d7 Minimum variant level data for somatic cancer #AMP2016
8:28am November 12th 2016 via Twitter Web Client
Lillian Siu (Princess Margaret Ontario CAN) Matching drugs to actionable targets #AMP2016
8:25am November 12th 2016 via Twitter Web Client
Q: Datasharing and CIVIC db? Li:Aware of multiple db's, CIVIC has 9 categories. #AMP2016
8:01am November 12th 2016 via Twitter Web Client
Re ClinVar progress Li: There is a somatic working group, to starting that effort. #AMP2016
7:59am November 12th 2016 via Twitter Web Client
Q: JAK2 for prognostic? Li: Off-label, not in guidelines, trials are ongoing. For Rx may take a bit longer. Illustrates evolution #AMP2016
7:58am November 12th 2016 via Twitter Web Client
Nikiforova: Only if you have validated for germline as well; may refer to other labs. #AMP2016
7:57am November 12th 2016 via Twitter Web Client
Q: Reporting germline? Li: Tumor/normal pairs will give info; but with only one sample, guidelines are given. #AMP2016
7:56am November 12th 2016 via Twitter Web Client
Li: Credits Robyn Temple-Smolkin @Robyn_Temple *hi Robyn!) and Mrudula Pullambhatla for their support from AMP #AMP2016
7:55am November 12th 2016 via Twitter Web Client
Li: 'Cancer genomics is a rapidly evolving field, the clinical sig of any var should be re-evaluated on an ongoing basis' #AMP2016
7:53am November 12th 2016 via Twitter Web Client
Li: And Pg 3 w/methods, what genes were tested. W/250 genes, they put a link to gene content online #AMP2016
7:52am November 12th 2016 via Twitter Web Client
Li: Shows a mock report, where summary of findings are at the top. Page 2 w/detailed interpretation, include table. #AMP2016
7:51am November 12th 2016 via Twitter Web Client
Li: Clinical sig of the var should be clearly described, but additional info not available to the lab should be kept in mind #AMP2016
7:49am November 12th 2016 via Twitter Web Client
Li: Gives example of 1p/19q co-deletion for gliomas. Variant nomenclature should be by HUGO designations; Gene name, xcrpt ID #AMP2016
7:48am November 12th 2016 via Twitter Web Client
Li: Tier IV is not rec'd to include in report, but be made available. Pertinent 'negatives' should be, in disease-spec manner #AMP2016
7:47am November 12th 2016 via Twitter Web Client
Li: Case example: diffuse midline glioma; large chart comparing Tiered vs current system ('pathogenic') w/both somatic, germline #AMP2016
7:46am November 12th 2016 via Twitter Web Client
Li: VUS and Benign (Type III/IV), tables shown of mutants from an AML sample. #AMP2016
7:42am November 12th 2016 via Twitter Web Client
Li: Tier II: Ph-like ALL, GENEA1-JAK2, where Jak inh can be used off-label. #AMP2016
7:40am November 12th 2016 via Twitter Web Client
Li: Example of Tier I in NSCLC: EGFR Exon 19 18bp inframe del, not in HGMD, ClinVar is somatic. Large table, IGV, other data #AMP2016
7:39am November 12th 2016 via Twitter Web Client
Li: Tier III not significant AF, no convincing cancer assoc'n evidence. Tier IV: benign or likely benign. Sig AF in general pop #AMP2016
7:37am November 12th 2016 via Twitter Web Client
Li: Tier II variants of potential clinical significance; Level C-D evidence. Tier III is unknown clinical significance #AMP2016
7:36am November 12th 2016 via Twitter Web Client
Li: For categorization of variants, Tiers I-IV. Tier I Vars of strong clin significance - Level A-B evidence #AMP2016
7:35am November 12th 2016 via Twitter Web Client
