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Feb 13, 2020

Genomic Assays in the “Real” Oncology World — Part 1: Genomic Assays and Colorectal Cancer — Featuring a roundtable discussion with Drs Emmanuel S Antonarakis, Johanna Bendell, Ian E Krop and Andrew McKenzie.

  • Multiplex Genomic Assays and Their Role in Therapeutic Decision-Making
  • Case: A man in his mid-80s with metastatic castration-resistant prostate cancer (mCRPC) whose disease progressed through multiple therapies is found to have CD274 (PD-L1) amplification, microsatellite instability (MSI)-high status and mutations in ATM and EGFR
  • Effect of CD274 amplification on response to immune checkpoint inhibitors; activity of PARP inhibitors in patients with ATM mutations
  • Advantages and limitations of multiplex genomic testing
  • Role of serial testing to identify variations in genomic mutations or aberrations over time; potential benefit of liquid next-generation sequencing (NGS) panels
  • Use of multiplex genomic assays by community oncologists and implications for clinical practice
  • Optimal timing of genetic testing for patients diagnosed with metastatic disease
  • Presentation (Dr McKenzie): Overview of multiplex genomic assay methodology
  • Rationale for the use of serial testing and liquid assays to identify variations in genomic mutations or aberrations over time
  • Differentiating between germline and somatic mutations in cancer tissue
  • Perspective on the use of tissue versus liquid biopsy for genetic testing
  • Sensitivity of liquid biopsies in detecting tumor mutations
  • Available data exploring the impact of NGS use on patient outcomes
  • Selection of a multiplex genomic assay for detecting genetic alterations
  • Implications of multiplex genomic assay results for therapeutic decision-making
  • Comprehensive Genetic Profiling and Precision Medicine for Metastatic Colorectal Cancer (mCRC)
  • Specific biomarkers and genetic alterations routinely evaluated in clinical practice
  • Effects of up-front multiplex genomic assay testing on outcomes for patients with mCRC
  • Response to immune checkpoint inhibitors in patients with MSI-high mCRC (1:09:3s
  • Presentation (Dr Bendell): Biomarker assessment in mCRC; role of multiplex testing
  • Actionable genetic alterations in mCRC; detection of BRAF and HER2 mutations and implications for practice
  • Rationale and indications for the assessment of MSI and DNA mismatch repair (MMR) status; emerging role of tumor mutational burden
  • Role of liquid versus tumor biopsies for detecting genetic alterations
  • MSI/MMR and tumor mutational burden as predictors of benefit from immune checkpoint inhibitors
  • Emerging role for the assessment of neoantigen load
  • Case (Dr Bendell): A man in his mid-50s with mCRC, Lynch syndrome and MSI-high status achieves a partial response to pembrolizumab as second-line therapy
  • Case (Dr Bendell): A woman in her early 60s with microsatellite stable mCRC and a BRAF V600E mutation receives the combination of cetuximab, encorafenib and binimetinib after disease progression on FOLFOXIRI/bevacizumab
  • Case (Dr Bendell): A man in his early 40s with HER2-positive mCRC receives trastuzumab and pertuzumab on a clinical trial after disease progression on FOLFIRI/bevacizumab and attains a partial response
  • Novel HER2-targeted therapies under evaluation for patients with mCRC and HER2 alterations
  • Analysis of the gut microbiome and strategies to enhance the immune response to cancer


CME information and select publications