Short Courses and Special Courses

Tumor Immunology: Implications for TNM Staging and Therapeutics

Monday, March 19, 2018 - 1:00 PM - 5:00 PM

Session Credits:

3.75 CME and 3.75 SAMs

Course Directors:

Janis M. Taube, MD, The Johns Hopkins University School of Medicine, Baltimore, MD
Robert A. Anders, MD, PhD, The Johns Hopkins University School of Medicine, Baltimore, MD

Faculty:

Kurt Schalper, MD, Yale University School of Medicine, New Haven, CT
Scott J. Rodig, MD, PhD, Harvard University, Boston, MA
Stuti G. Shroff, MD, PhD, Hospital of the University of Pennsylvania, Philadelphia, PA
Lynette M. Sholl, MD, Brigham and Women’s Hospital, Boston, MA
Jerome Galon, MD, Centre de Recherche des Cordeliers de Jussieu, Paris, France
Ashley Cimino-Mathews, MD, The Johns Hopkins University School of Medicine, Baltimore, MD
David Rimm, MD, PhD, Yale University School of Medicine, New Haven, CT

Course Description

The recent success of immune based cancer therapy is changing the practice of pathology. In order to prepare practicing pathologists this course will explain the current and future approach to evaluating patient specimens. This course will specifically address TNM-Immune staging and the emerging use of surgical pathology specimens for immune-based assays, including immunologic biomarkers for therapeutic selection and monitoring. Upon conclusion of the course, participants will be able to address questions they receive from treating physicians, oncologists and patients regarding predictive and prognostic immune biomarkers, histologic features of adverse immune reactions and evaluation PD-L1 immunohistochemistry.

Learning Objectives

Upon completion of this educational activity, learners will be able to:

  • Summarize how the activity of checkpoint agents differs from that of more traditional therapeutics
  • Summarize the latest concepts regarding the immune contexture of malignant neoplasms
  • Discuss the histologic features associated with adaptive immune resistance
  • Understand the limitations of PD-L1 evaluation
  • Identify additional markers and associated detection techniques that will likely be employed in future Immunopathology assays

 

1:00 PM Checkpoint Blockade Therapy and Proposed Biomarkers for Patient Selection: An Overview and Update

Kurt Schalper, MD, Yale University School of Medicine, New Haven, CT

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

  • Understand the current role of immune checkpoint blockers as anti-cancer agents.
  • Discuss the value and limitations of current biomarkers for prediction of response/resistance to immune checkpoint blockers.
  • Describe novel strategies to evaluate the anti-tumor immune response in biopsy samples.
1:25 PM Checkpoint Blockade Therapy and Proposed Biomarkers for Patient Selection: An Overview and Update

Scott J. Rodig, MD, PhD, Harvard University, Boston, MA

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

  • Understand the genetic bases for immune evasion in classical Hodgkin lymphoma
  • Understand the role of the micro-environment in enhancing immune evasion in Hodgkin lymphoma
  • Recognize the impact of immune evasion strategies on the selection of appropriate immune therapies
  • Identify types of non-Hodgkin lymphoma that use similar immune evasion strategies and therapeutic strategies for their treatment 
1:50 PM Clinicopathologic Features Associated with Adverse Events in Immune Based Cancer Therapy

Stuti G. Shroff, MD, PhD, Hospital of the University of Pennsylvania, Philadelphia, PA

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

  • Discuss sites of involvement and general clinicopathologic features of immune therapy related adverse events.
  • Recognize the histopathologic changes from immune based cancer therapy in the gastrointestinal tract.
  • Identify the importance of clinical history and the onset of therapy in helping to define the pathologic sequela of immune blockade.
2:15 PM Non-Small Cell Lung Carcinoma: The Tumor Immune Microenvironment

Lynette M. Sholl, MD, Brigham and Women’s Hospital, Boston, MA

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

  • Identify components of the NSCLC tumor immune microenvironment
  •  Compare and contrast treatment indications and PD-L1 assay strategies for lung squamous cell carcinoma vs. adenocarcinoma
  •  Discuss potential biomarkers beyond PD-L1 including tumor mutation burden and mutational signatures and their potential relationship to therapeutic outcomes
2:40 PM The Immunoscore

Jerome Galon, MD, PhD, Centre de Recherche des Cordeliers de Jussieu, Paris, France

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

  • Summarize how the Immunoscore performs compared to current TNM staging
  • Understand how an Immunoscore is calculated
  • Discuss the current status of the Immunoscore Task Force is validating this approach
3:05 PM Coffee Break
3:20 PM Mismatch Repair Deficiency as a Predictive Biomarker in Multiple Tumor Types for Anti-PD-1 Blockade Immune Based Cancer Therapy

Robert A. Anders, MD, PhD, The Johns Hopkins University School of Medicine, Baltimore, MD

Upon completion of this activity, learners will be better able to:

  • Understand the events leading to the development of anti-PD-1 in cancer
  • Discuss the limitations of methods used to determine mismatch repair deficiency status
  • Identify the next challenges in screen multiple tumor types for mismatch repair status
3:45 PM The Breast Tumor Immune Microenvironment

Ashley Cimino-Mathews, MD, The Johns Hopkins University School of Medicine, Baltimore, MD

Upon completion of this activity, learners will be better able to:

  • Identify the components of the breast tumor immune microenvironment
  • Compare and contrast the tumor microenvironment of in situ and invasive breast carcinoma
  • Discuss the features of the tumor microenvironment unique to special subtypes of invasive carcinoma
4:10 PM PD-1/PD-L1 axis in cutaneous malignancies and scoring response to anti-PD-1 in the neoadjuvant setting

Janis M. Taube, MD, The Johns Hopkins University School of Medicine, Baltimore, MD

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

  • Understand PD-L1-mediated adaptive immune resistance and the associated biomarker implications for patients with melanoma.
  • Introduce the benefits of computer-assisted modalities for quantifying features of the PD-1/PD-L1 axis using specimens from patients with Merkel cell carcinoma.
  • Learn features of immune-mediated tumor regression and how to score percent residual viable tumor in this setting.
4:35 PM PD-L1 The Original Companion Diagnostic Test for Immune Therapy; Previous Mishaps and Future Potential

David Rimm, MD, PhD, Yale University School of Medicine, New Haven, CT

Upon completion of this activity, learners will be better able to:

  • Define the Complementary vs Companion Diagnostic tests and describe the current status of PD-L1 testing
  • Review of the Current PD-L1 assays and antibodies and literature on comparisons and standardization
  • Share data on next generation PD-L1 based tests including mRNA signature, protein signatures and other PD-L1 related assays

Continuing Medical Education and Maintenance of Certification

The United States and Canadian Academy of Pathology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The United States and Canadian Academy of Pathology designates this live activity for a maximum of 3.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The USCAP is approved by the American Board of Pathology (ABP) to offer Self-Assessment credits (SAMs) for the purpose of meeting the ABP requirements for Maintenance of Certification (MOC). Learners must take and pass the post-test in order to claim SAMs credit.

Physicians can earn a maximum of 3.75 SAM credit hours.

 

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