In a recent interactive webinar, renowned experts Prof. Fernando López-Ríos, Assoc. Prof. Alicia Morgans and Assoc. Prof. Herbert Loong came together to explore precision oncology in practice for lung and prostate cancer.

 

Watch the on-demand video to hear the medical experts discuss how to address pre-analytical phase challenges during molecular testing, and the relevant biomarkers and tests to request for lung and prostate cancer patients.

 

Topics of conversation included:

  • An overview of common challenges related to biomarker testing across all tumour types
  • Challenges and considerations of biomarker testing for lung and prostate cancer throughout the patient journey

The event concluded with speakers and participants engaging in a Q&A to address pressing questions.

Watch the video replay and download the accompanying slides for your reference.

 

Clinical Takeaways

  • Molecular testing with next-generation sequencing of DNA and RNA should be considered standard of care where possible using high-quality, sufficient tissue samples for accurate biomarker testing
  • Pathologists should conduct ‘reflex testing’ after histologic diagnosis of lung cancer, and liquid biopsies should be utilised as a complementary testing method or when tumour tissue is not feasible
  • Germline and somatic genetic testing in advanced prostate cancer may identify patients with HRR mutations and MSI-H who could be suitable for highly effective targeted agents
  • Multidisciplinary team or molecular tumour board discussion can facilitate interpretation of biomarker data, leading to more accurate patient stratification, treatment selection, and clinical decision-making

Educational objectives

  • Know how to address pre-analytical phase challenges and how to collect, store, process and prepare the samples
  • Have an awareness of which biomarkers and tests to request
  • Understand the diagnostic modalities and the role of biomarkers in oncology
  • Be able to implement or improve the leading role of the pathologist on the MDT 

López-Ríos F, Illei PB, Rusch V, Ladanyi M. Multiple lines of evidence against a role for SV40 infection in human mesotheliomas and high risk of false-positive SV40 PCR results due to presence of SV40 sequences in common laboratory plasmids. Lancet 2004; 364: 1157-1166. Conde E, Angulo B, Tang M, Morente M, Torres-Lanzas J, López-Encuentra A, López-Ríos F, Sánchez-Céspedes M. Molecular context of the epidermal growth factor receptor mutations: evidence for the activation of mTOR/S6K signalling. Clin Cancer Res 2006; 12: 710-717. López-Ríos F, Chuai S, Flores R, Shimizu S, Ohno T, Wakahara K, Illei PB, Hussain S, Krug L, Zakowski MF, Rusch V, Olshen AB, Ladanyi M. Global gene expression profiling of pleural mesotheliomas. Overexpression of aurora kinases and P16/CDKN2A deletion as prognostic factors and critical evaluation of microarray-based prognostic prediction. Cancer Res 2006; 66: 2970-2979. López-Ríos F, Sánchez-Aragó M, García-García E, Ortega AD, Berrendero JR, Pozo-Rodríguez F, López-Encuentra A, Ballestín C, Cuezva JM. Loss of the mitochondrial bioenergetic capacity underlies the glucose avidity of Carcinomas. Cancer Res 2007; 67: 9013-9017. Angulo B, Suarez-Gauthier A, López-Ríos F, Medina PP, Conde E, Tang M, Soler G, Lopez-Encuentra A, Cigudosa JC, Sanchez-Cespedes M. Expression signatures in lung cancer reveal a profile for EGFR-mutant tumours and identify selective PIK3CA overexpression by gene amplification. J Pathol 2008; 214: 347-356. Agulló-Ortuño MT, López-Ríos F, Paz-Ares L. Lung cancer genomic signatures. J Thorac Oncol 2010; 5: 1673-1691. Thunnissen E, Bubendorf L, Dietel M, Elmberger G, Kerr K, Lopez-Rios F, Moch H, Olszewski W, Pauwels P, Penault-Llorca F, Rossi G. EML4-ALK testing in non-small cell carcinomas of the lung: a review with recommendations. Virchows Arch 2012; 461: 245-257. Conde E, Angulo B, Izquierdo E, Muñoz L, Suárez-Gauthier A, Plaza C, Dominguez N, Torres M, Madrigal L, Rubio-Viqueira B, Belda-Iniesta C, Hidalgo M, López-Ríos F. The ALK translocation in advanced non-small-cell lung carcinomas: preapproval testing experience at a single cancer centre. Histopathology 2013; 62: 609-616. Conde E, Suárez-Gauthier A, Benito A, Garrido P, García-Campelo R, Biscuola M, Paz-Ares L, Hardisson D, de Castro J, Camacho MC, Rodriguez-Abreu D, Abdulkader I, Ramirez J, Reguart N, Salido M, Pijuán L, Arriola E, Sanz J, Folgueras V, Villanueva N, Gómez-Román J, Hidalgo M, López-Ríos F. Accurate identification of ALK positive lung carcinoma patients: novel FDA-cleared automated fluorescence in situ hybridization scanning system and ultrasensitive immunohistochemistry. PLoS One 2014; 9: e107200. Bubendorf L, Büttner R, Al-Dayel F, Dietel M, Elmberger G, Kerr K, López-Ríos F, Marchetti A, Öz B, Pauwels P, Penault-Llorca F, Rossi G, Ryška A, Thunnissen E. Testing for ROS1 in non-small cell lung cancer: a review with recommendations. Virchows Arch 2016; 469: 489-503. Kerr KM, López-Ríos F. Precision medicine in NSCLC and pathology: how does ALK fit in the pathway? Ann Oncol. 2016: Suppl 3:iii16-iii24. Büttner R, Gosney JR, Skov BG, Adam J, Motoi N, Bloom KJ, Dietel M, Longshore JW, López-Ríos F, Penault-Llorca F, Viale G, Wotherspoon AC, Kerr KM, Tsao MS. Programmed Death-Ligand 1 Immunohistochemistry Testing: A Review of Analytical Assays and Clinical Implementation in Non-Small-Cell Lung Cancer. J Clin Oncol 2017; 35: 3867-3876. Conde E, Caminoa A, Dominguez C, Calles A, Walter S, Angulo B, Sánchez E, Alonso M, Jimenez L, Madrigal L, Hernando F, Sanz-Ortega J, Jimenez B, Garrido P, Paz-Ares L, de Castro J, Hernandez S, Lopez-Rios F. Aligning digital CD8(+) scoring and targeted next-generation sequencing with programmed death ligand 1 expression: a pragmatic approach in early-stage squamous cell lung carcinoma. Histopathology 2018; 72: 270-284. Yatabe Y, Dacic S, Borczuk AC, Warth A, Russell PA, Lantuejoul S, Beasley MB, Thunnissen E, Pelosi G, Rekhtman N, Bubendorf L, Mino-Kenudson M, Yoshida A, Geisinger KR, Noguchi M, Chirieac LR, Bolting J, Chung JH, Chou TY, Chen G, Poleri C, Lopez-Rios F, Papotti M, Sholl LM, Roden AC, Travis WD, Hirsch FR, Kerr KM, Tsao MS, Nicholson AG, Wistuba I, Moreira AL. Best Practices Recommendations for Diagnostic Immunohistochemistry in Lung Cancer. J Thorac Oncol 2019; 14: 377-407. Büttner R, Longshore JW, López-Ríos F, Merkelbach-Bruse S, Normanno N, Rouleau E, Penault-Llorca F. Implementing TMB measurement in clinical practice: considerations on assay requirements. ESMO Open 2019; 4: e000442.

Prof. Fernando López-Ríos has received financial support/sponsorship for research support, consultation, or speaker fees from the following companies:

AstraZeneca, Bayer, BMS, Lilly, MSD, Pfizer, Roche, Takeda and Thermo Fisher. 

 

Dr Morgans is Genitourinary Medical Oncologist at Dana-Farber Cancer Institute, and Faculty in Medicine at Harvard Medical School in Boston, MA. She completed medical school and residency at the University of Pennsylvania School of Medicine, fellowship in Hematology/Oncology at Harvard’s Dana Farber Cancer Institute and Massachusetts General Hospital Cancer Center in Boston and earned a Master of Public Health at Vanderbilt University. Dr Morgans treats patients with prostate, bladder, and testicular cancer, and her research assesses complications of advanced prostate cancer survivorship and patient-centered treatment decision-making in advanced prostate cancer.

Assoc. Prof. Alicia Morgans has received financial support/sponsorship for research support, consultation, or speaker fees from the following companies:

AAA, Astellas, AstraZeneca, Bayer, Exelixis, Janssen, Myovant, Novartis, Pfizer, Sanofi and Telix. 

Programme summary
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This educational programme is supported by an Independent Medical Education Grant from AstraZeneca and Amoy Diagnostics.
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PRECISION ONCOLOGY CONNECT is an initiative of COR2ED, supported by Independent Medical Educational Grants from AstraZeneca, Amoy Diagnostics and Bayer.

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