Agenda

Date and TimeTitle
Dec 7, 2020 (Eastern)
9:00am - 9:30am
Keynote: Precision Medicine Depends on Biopsy Quality

The promise of precision medicine is to enable doctors and patients to choose the therapy most likely to be effective for an individual.  The flipside is preventing that patient from exposure to drugs that won’t help.  The medical community has been working toward personalized medicine since 1999.  Yet, still today, relatively few therapies are chosen based on a predictive test.  There is a disconnect between this fact and the potential on display in the form of technological advances in testing methodology.  This discrepancy is partly explained by our lack of precision in biopsy quality.

Dec 7, 2020 (Eastern)
9:35am - 10:36am
KRAS: Pathologists Perspectives on Drugging the Undruggable

The KRAS gene is the most commonly mutated oncogene in human cancers. It has long evaded attempts to identify an actionable target for therapy, being considered “undruggable”. Recently a new class of cancer therapies has arrived whereby the KRAS G12C mutation has successfully been targeted. KRAS G12C is the most common KRAS mutation in lung adenocarcinoma, and among the most frequent KRAS mutations overall.

In this era of precision medicine, the work of pathologists has been fundamental to the development of care plans for cancer patients. By providing accurate diagnoses, identifying important prognostic factors and key actionable mutations, many patients are able to be matched with effective therapies, oftentimes minimizing the typical toxic side effects of traditional chemotherapy.

KRAS mutations are especially important in lung and GI cancers, present in about 25% of non-small cell lung cancer, 30-40% of colon cancer and the vast majority of pancreatic ductal adenocarcinoma. We will discuss the importance of KRAS in these cancers and how pathologists specifically identify these mutations. How does this emerging biomarker fit in with the workflow for identifying other approved targeted therapies? Learn what to expect as this significant advancement in precision medicine takes a new turn.

Dec 7, 2020 (Eastern)
10:40am - 11:30am
What do pathologists do to evaluate integration for new assays?
Dec 7, 2020 (Eastern)
11:35am - 12:05pm
Pathology and Precision Medicine in Oncology: New Technological Approaches to Bridging the Gap and Enabling Better Care

Pathology is the first critical component of the patient journey. It is particularly important in cancer treatment as the resulting pathways are literally life and death. Traditionally, pathology has determined the course of care by identifying the tissue, stage, grade and sometimes nuanced morphological characteristics critical to starting the patient on the correct path. However, in modern medicine the reliance on genetic and other biomarkers as part of the pathological diagnosis are becoming standard of care and vital in identifying the therapy (often precision) that matches best with the disease profile. Due to the rapid adoption of new reliance on biomarkers for many new treatments, education, reimbursement and access to timely test providers are all challenges that need to be addressed. Dr. Bowen will discuss some of the ways that technology is empowering the care team, starting with pathology, to provide the best care for patients in this evolving landscape.

Dec 7, 2020 (Eastern)
12:10pm - 12:55pm
Pathology and Radiology Collaboration for Integrated Reporting

Radiology and pathology results together are often used to make cancer diagnoses, yet even within the same institution, these disciplines typically live in silos without direct linkage. The American College of Radiology and the College of American Pathologists are collaborating to pilot and test an integrated diagnostic environment with cross-talk between imaging results and pathology interpretation. The goal of this collaboration is to not only help the diagnostic cancer reporting process to be more productive and efficient, but also directly contribute towards better patient care. Working together, these organizations are proposing a technical framework using the ACR RADS models and the CAP Cancer Protocol content to lay the foundation for a RadPath concordance workflow system, which would aim to improve clinical diagnosis as well as provide for better data accessibility, management, and more streamlined research.

Dec 7, 2020 (Eastern)
1:00pm - 1:38pm
Keynote: Computational Pathology as a Companion Diagnostic: Implications for Precision Medicine

With the advent of digital pathology, there is an opportunity to develop computerized image analysis methods to not just detect and diagnose disease from histopathology tissue sections, but to also attempt to predict risk of recurrence, predict disease aggressiveness and long term survival. At the Center for Computational Imaging and Personalized Diagnostics, our team has been developing a suite of image processing and computer vision tools, specifically designed to predict disease progression and response to therapy via the extraction and analysis of image-based “histological biomarkers” derived from digitized tissue biopsy specimens. These tools would serve as an attractive alternative to molecular based assays, which attempt to perform the same predictions. The fundamental hypotheses underlying our work are that: 1) the genomic expressions detected by molecular assays manifest as unique phenotypic alterations (i.e. histological biomarkers) visible in the tissue; 2) these histological biomarkers contain information necessary to predict disease progression and response to therapy; and 3) sophisticated computer vision algorithms are integral to the successful identification and extraction of these biomarkers. We have developed and applied these prognostic tools in the context of several different disease domains including ER+ breast cancer, prostate cancer, Her2+ breast cancer, ovarian cancer, and more recently medulloblastomas. For the purposes of this talk I will focus on our work in breast, prostate, rectal, oropharyngeal, and lung cancer.

Dec 7, 2020 (Eastern)
1:40pm - 2:20pm
Use of standardized structured datasets for pathology cancer to improve patient care and clinical outcomes.

The College of American Pathologists (CAP) Cancer Protocols have offered standardized guidance to pathologists for cancer pathology reporting for over 30 years. The adoption of computer implementable versions of these protocols by electronic health record (EHR) and laboratory information system (LIS) vendors provides a mechanism for pathologists to report within their LIS workflow, in addition to enabling standardized structured data capture and reporting to downstream data users such as researchers and public health entities. In this discussion we will review the history of the Cancer Protocols and electronic Cancer Checklists (eCC), the value and current use of these cancer reporting tools, and future direction.