Clinical Genomics Platform - Executive War College€¦ · Pathologists Role • Recognized...
Transcript of Clinical Genomics Platform - Executive War College€¦ · Pathologists Role • Recognized...
Clinical Genomics
Platform May 1, 2013
Joyceann Musel-Winn, MS, MT (ASCP)
Division Administrator
Division of Pathology and Laboratory Medicine
The University of Texas MD Anderson Cancer Center
• Making Cancer History
• Testing Patterns
• Pathologists Role
• Reimbursement
Clinical Genomics Platform
Moon Shot Strategies
• Acute myeloid leukemia and myelodysplastic
syndrome
• Chronic lymphocytic leukemia
• Lung Cancer
• Melanoma
• Prostate cancer
• Women’s cancers: breast and ovarian
Challenges
• Front door consent • Germ line controls– secondary research findings
• Discoverable mutations affecting family members
• Sample collection- quantity and quality • Interventional radiology
• Micro dissections
• Analyzers vary in quantity requirements
• Dynamic nature of the analytics • Expensive and getting faster, smaller and cheaper
• DNA, RNA, CTC, Free DNA, proteins
• Informatics- Amount of data!
Challenges Continued
• Informatics • Software and pathologist time to interpret
• Integration of all CG testing • Collaborate with Medical Oncologist
• Collaborate with Physician Scientists
• Storage • Searchable data for future review and comparisons
• Specimens, several types (frozen tissue, FFPE, serum, RNA, patient controls)
• Robotic Freezers
• Reimbursement panels vs. single CG test
Pathologists Role
• Recognized authority for Clinical Genomic testing
• Work with IR physicians to assess the biopsy sample POC,
including evaluating cellularity
• After reviewing and interpreting the tissue, marks slide to best
capture the tumor for the DNA extraction
• Interpret sequencing data for gene mutations
• Review patient clinical history and literature to correlate with
findings and possible contraindications to targeted therapy
• Collaborate with the Medical Oncologists for best treatment,
diagnosis and prognosis.
• Reimbursement- pathologists provide clinical vignettes to
support medical necessity