2015 Annual Meeting

Molecular Diagnostic and Genomic Applications in Cancer:  A Primer for the Pathologist

2015 Annual Meeting

Room CC Ballroom C, March 24 2015, 8:00am to 5:15pm

Special Course- Molecular Diagnostic and Genomic Applications in Cancer: A Primer for The Pathologist

Educational Objective

The pathologist is increasingly expected to play a central role in the management of cancer patients in the era of personalized oncology. Molecular diagnostic and genomic applications are rapidly penetrating the daily practice of the pathologist as the list of actionable genetic alteration in solid and hematologic tumors continues to expand. As highlighted in the USCAP 2012 combined companion meeting of “the Association for Molecular Pathology Joint Meeting with American Society for Clinical Pathology In Coordination With American Society for Investigative Pathology”, efforts to develop residency curricula that will address the educational needs in molecular and genomic pathology for pathologists in training are underway by some academic institutions and others. These initiatives include the efforts sponsored by the Training Residents in Genomics (TRIG) working group of the Pathology Residency Directors Section of the Association of Pathology Chairs. Similar educational needs are evident among practicing pathologist in the community and academic centers, pathology residents and fellows in institutions that are yet to develop a formal curriculum. A survey of the positive responsesfrom attendees of the “sold out”special course titled “Basic Principles and Practice of Molecular Pathology in Cancer”,which was in its final iteration at USCAP 2012, is very indicative of an urgent and important educational need. The current course proposal intends to build upon and extend the role that the latter course, that is no longer offered, fulfilled.In fact, the proposal stems from the shared recognition of the AMP, ASIP and ASCP organizations that sponsored the 2012 combined companion meeting and from the director and faculty of the previous special course that there is the continuous need to offer educational opportunities to augment medical knowledge and to address competency deficiencies among the intended target audience, which is, primarily, the group of anatomic pathologists. Target Audience: Practicing pathologists in all settings

  1. Pathology residents (especially those from institutions that are yet to develop a formal curriculum)
  2. Oncologic and organ based Surgical Pathology fellows
  3. Translational scientists interested in focusing their research on developing molecular genetic pathology applications

Upon completion of the educational activity, participants should be able to:

  1. Emphasize the basic principles of molecular pathology in cancer and their application to laboratory medicine and clinical practice. This will be carried out in a format designed to be practical and straightforward.
  2. Specifically, this course is aimed at providing pathologists with a foundation in the practice of oncologic molecular diagnostic pathology to include: nomenclature, commonly used techniques and their specimen requirements, assay selection and indications, diagnostic and prognostic utility, therapeutic ramifications, test turn-around-times, and quality assurance.
  3. Select cases may be presented to illustrate use in routine practice and serve as useful paradigms.
  4. Specific areas will be highlighted in which major advances in genomic applications for site-specific solid tumors and hematologic neoplasms are taking place. The latter will be done with the anatomic pathologist in mind and thus discussed in practical manner with only brief and digested discussion of esoteric technical principles that are not in the anatomic pathologist domain.

Session Credits: CME = 7.5 / SAMs = N/A

Agenda

8:00am
Introduction
Speaker: George J. Netto, MD, The Johns Hopkins University, Baltimore, MD
8:00am
Special Course Course Director
Speaker: George J. Netto MD, The Johns Hopkins University, Baltimore, MD
8:00am
Special Course Course Director
Speaker: Iris Schrijver, MD, Stanford University, Stanford CA
8:10am
Current Next Generation Sequencing Technology: A Primer for the Pathologist
Speaker: Iris Schrijver, MD, Stanford University, Stanford CA

Upon completion of this educational activity, participants should be able to:

  1. Discuss the overall principles of massively parallel sequencing (next generation sequencing) technologies.
  2. Illustrate practical examples of NGS based clinical diagnostics and how it will be impacting daily practice of pathology.
8:50am
Next-Gen Surgical Pathology: New Opportunities and Challenges
Speaker: Karen Kaul MD, PhD. North Shore University Health System, Evanston, IL

Upon completion of this educational activity, participants should be able to:

  1. Discuss how the evolving understanding of molecular events underlying cancer development is making molecular characterization of tumors a necessity for diagnosis and prognostication in the practice of the pathologist.
  2. Present an overview of the evolution of molecular testing from single gene or mutation analysis to multiplex capabilities including next generation sequencing.
  3. Discuss the challenges and opportunities associated with the incorporation of these tools into the daily practice of the pathologist.
Access to Handouts
9:20am
Molecular Markers for Targeted Lung Cancer Therapy
Speaker: John Iafrate, MD, PhD, Massachusetts General Hospital, Boston, MA

Upon completion of this educational activity, participants should be able to:

  1. State the current genetic landscape of lung tumors.
  2. Identify the role of genetic testing in guiding targeted therapies in lung cancer.
  3. Appreciate the importance of advanced technologies in the future of pathologic assessment of tumors.
Access to Handouts
10:00am
Break/Poster Session
10:30am
Molecular Testing in the Management of Patients with Breast Cancer: Current Status and Future Directions
Speaker: Stuart J. Schnitt, MD, Beth Israel Deaconess Medical Center, Boston, MA

Upon completion of this educational activity, participants should be able to:

  1. Explain the molecular classification of breast cancer and its clinical implications.
  2. Review the uses and limitations of currently available molecular prognostic tests for patients with breast cancer.
  3. Describe the emerging role of exome /whole genome sequencing in the management of patients with breast cancer.
Access to Handouts
11:00am
Clinical Cytogenetic and Molecular Genetic Testing in Bone and Soft Tissue Tumors
Speaker: Julia A. Bridge, MD, University of Nebraska Medical Center, Omaha, NE

Upon completion of this educational activity, participants should be able to:

  1. Review sample requirements and handling for RT-PCF, FISH, and cytogenetic analysis as they pertain to evaluating mesenchymal neoplasms.
  2. Describe the advantages and limitations of genetic approaches commonly used in the classification of mesenchymal neoplasms to include conventional karyotyping, FISH and RT PCR.
  3. Recognize the diagnostic, prognostic, and therapeutic value of molecular markers in mesenchymalneoplasia.
Access to Handouts
11:40am
GIST and Melanoma: The KIT Connection and So Much More
Speaker: Alexander Lazar, MD, PhD, University of Texas M. D. Anderson Cancer Center, Houston, TX

Upon completion of this educational activity, participants should be able to:

  1. Illustrate the techniques and results of molecular testing for gastrointestinal stromal tumor (GIST) and melanoma.
  2. Recognize the association between histologic and molecular features in GIST and melanoma.
  3. Interpret the emerging role of molecular diagnostics in patient management for GIST and melanoma.
Access to Handouts
12:10pm
Lunch Break
1:10pm
Molecular Diagnostics of Lymphoma: Assays for Classification, Outcome Prediction and Therapy Response
Speaker: Dan Jones, MD, PhD, Quest Diagnostics Nichols Institute, Chantilly, VA

Upon completion of this educational activity, participants should be able to:

  1. Select the appropriate and most cost-effective molecular and cytogenetic testing for workup of lymphomas and tissue-based leukemic infiltrates of various types
  2. Assess the technology, limitations and benefits of next generation mutation, array and transcriptional profiling in lymphomas.
  3. Describe the emerging role of exome/whole genome sequencing in the management of patients with lymphoma.
1:50pm
Colorectal Cancer: Molecular Testing for the Surgical Pathologist
Speaker: Kevin C. Halling, MD, PhD, Mayo Clinic, Rochester, MN

Upon completion of this educational activity, participants should be able to:

  1. Discuss how MSI and DNA mismatch repair IHC testing and germline DNA mismatch repair gene sequencing are used to identify, diagnose, and manage patients with HNPCC.
  2. Explain how microsatellite instability testing can be used to assess stage II and III CRC patients? prognosis and response to 5FU treatment.
  3. Describe how KRAS and BRAF testing can be used to predict response to anti-EGFR therapies for patients with metastatic colorectal cancer (CRC).
  4. Describe the emerging role of exome/whole genome sequencing in the management of patients with colorectal cancer.
2:30pm
Clinical Applications of Recent Molecular Advances in Prostate Cancer
Speaker: George J. Netto, MD, The Johns Hopkins University, Baltimore, MD

Upon completion of this educational activity, participants should be able to:

  1. Review ?translationally? pertinent advances in our understanding of the molecular pathogenesis of prostate cancer.
  2. Recognize upcoming novel diagnostic and prognostic markers in prostate cancer.
3:00pm
Break/Poster Session
3:30pm
Molecular Diagnostics of CNS Tumors
Speaker: Arie Perry, MD, UCSF School of Medicine, San Francisco, CA

Upon completion of this educational activity, participants should be able to:

  1. Review the most common molecular alterations in CNS tumors
  2. Recognize the association between histologic and molecular features in CNS tumors.
  3. Interpret the emerging role of molecular diagnostics in patient management for CNS tumors
4:00pm
Molecular Diagnostics of Leukemia: Classification, Outcome Prediction and Therapy Response
Speaker: Daniel Arber, MD, Stanford University, Stanford, CA

Upon completion of this educational activity, participants should be able to:

  1. Select the appropriate and most cost-effective molecular and cytogenetic testing for workup of leukemia.
  2. Assess the technology, limitations and benefits of next generation mutation, array and transcriptional profiling in leukemia.
  3. Describe the emerging role of exome/whole genome sequencing in the management of patients with leukemia.
4:30pm
Molecular Diagnostics of Thyroid Cancer
Speaker: Yuri E. Nikiforov, MD, PhD, University of Pittsburgh, UPMC Presbyterian, Pittsburgh, PA

Upon completion of this educational activity, participants should be able to:

  1. Review the most common molecular alterations in thyroid tumors and their histopathologic correlates.
  2. Discuss specimen requirements and techniques for molecular testing of thyroid surgical resections and fine needle aspiration (FNA) samples.
  3. Describe the diagnostic and prognostic application of specific molecular markers in thyroid cancer.
Access to Handouts
5:00pm
Question Period and Concluding Remarks

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