Simon: GWU and CW connected for public health new-data initiatives. Advice: "Answer your phone, and speak with random people" #PMWC17
10:46am January 24th 2017 via Hootsuite
Gregory Simon (White House, Cancer Moonshot) An update on the Cancer Moonshot and BRAIN Government Intitiatives #PMWC17
10:42am January 24th 2017 via Hootsuite
Paz: Of $3T spend, 30% wasted. 60% admin waste, 40% clinical waste. 40% social determinants for health; 10% hospital, 50% genetics #PMWC17
7:47pm January 23rd 2017 via Hootsuite
Nadauld: Intermountain went away from a fee-for-service model to a value-based model, decreasing utilization w/incentives for health #PMWC17
7:39pm January 23rd 2017 via Hootsuite
Nadauld: If we don't come up with standards ourselves (for actionable genes), CMS or others will do it for us. #PMWC17
7:35pm January 23rd 2017 via Hootsuite
Burd: Quality of assay 'a major concern for us' (she's a patient advocate). Need to separate actionable and useful for future use #PMWC17
7:34pm January 23rd 2017 via Hootsuite
Nadauld: And not only tests but annotation. Has heard 'WGS when you are born' to 'we don't know what any of it means'. Truth: midway #PMWC17
7:32pm January 23rd 2017 via Hootsuite
Krumholz: "It's the quality of the test that concerns me the most. Nadauld: Standardization is a 'must'. #PMWC17
7:31pm January 23rd 2017 via Hootsuite
Paz: So much quantity and quality of data provided to physicians, and then to patients. Some actionable, some not. Filters? #PMWC17
7:30pm January 23rd 2017 via Hootsuite
Krumholz: Lots of missing pieces - nothing is longitudinally linked. "The records exist." But held by different entities... #PMWC17
Paz: Blockchain? Krumholz: Public and private chains - private ones can be lost. Healthcare application - maybe down the line. #PMWC17
7:29pm January 23rd 2017 via Hootsuite
Krumholz: It has to be people first, not able to be de-identified and sold in secret, has to be convenient, from connected devices #PMWC17
7:28pm January 23rd 2017 via Hootsuite
Burd: Ideally, patients would carry it around in their smartphone. Nadauld: the next generation will demand that. #PMWC17
7:26pm January 23rd 2017 via Hootsuite
Nadauld: It is the empowerment of patients, to understand their own data. Paz: Are there platforms out there today? #PMWC17
7:24pm January 23rd 2017 via Hootsuite
Krumholz: ...and we won't know the value of a personalized approach. Nadauld: Your data no longer can be a black box. #PMWC17
Krumholz: Give people the power, and make 'the researchers beg for it'. A need for the data to move. #PMWC17
7:23pm January 23rd 2017 via Hootsuite
Krumholz: Such a separation between aspirations here at #PMWC17, and the realities of healthcare. What is the value to the individual?
7:22pm January 23rd 2017 via Hootsuite
Krumholz: Need to understand how health progresses. But the info gets 'mostly lost, and shielded from being useful clinically' #PMWC17
Round-table discussion - Krumholz "We need greater liquidity of patient data" - people owning their own data, being able to move it #PMWC16
7:21pm January 23rd 2017 via Hootsuite
Harold Paz Aetna Lincoln Nadauld Intermountain Amy Burd LLS Harland Krumholz (Yale) Moving Precision Medicine to Precision Health #PMWC17
7:18pm January 23rd 2017 via Hootsuite
Q: What's the next big thing? Rosenfeld: Highly sensitive that can pick up residual disease. Now more optimistic than before. #PMWC17
6:30pm January 23rd 2017 via Hootsuite
Q: have we met the limit of sensitivity? Rosenfeld: Can detect as few as three molecules; sample prep upfront is the work #PMWC16
6:28pm January 23rd 2017 via Hootsuite
Morris: (Here's the Clinical https://t.co/byUd2BT8MU website with the currently-enrolling Grail study https://t.co/7Qh02x1jm2 ) #PMWC17
6:21pm January 23rd 2017 via Hootsuite
Morris: ctDNA can aid early Dx, Grail is currently recruiting, and thus can widen scope of pts who can get intervention #PMWC17
6:19pm January 23rd 2017 via Hootsuite
Morris: Long list of profiling, monitoring, and early Dx companies for ctDNA. Stratification has already begun using ctDNA #PMWC17
6:12pm January 23rd 2017 via Hootsuite
Morris: Shows Piper Jaffray estimate of a $28B market opportunity. Sept 2015 to Sept 2016 $336M raised. #PMWC16
6:10pm January 23rd 2017 via Hootsuite
Govindan: Can detect down to 0.1%, many responders had low allele frequency. #PMWC17
6:09pm January 23rd 2017 via Hootsuite
Govindan: Current assays have limited sensitivity - Oxnard et al reports 58-77%. #PMWC17
6:04pm January 23rd 2017 via Hootsuite
Govindan: Plasma analysis tends to detect mutations shared between multiple tumor regions; can determine emerging areas of resist #PMWC17
Govindan: Sampling a tumor with a fine needle - versus looking at the entire hetergeneous mix in the bloodstream. #PMWC17
6:01pm January 23rd 2017 via Hootsuite
Govindan: Tumor heterogeneity - a single biopsy may be misleading - as different areas will have different subclone derived cells #PMWC17
6:00pm January 23rd 2017 via Hootsuite
Govindan: JAMA '16 https://t.co/wV8HetlSKa prospectively comparing ctDNA vs tissue - 3 weeks longer for tissue #PMWC17
5:58pm January 23rd 2017 via Hootsuite
Govindan: Showed data from this Roche cobas clinical trial ref '15 https://t.co/OeBcDfLtWk #PMWC17
5:56pm January 23rd 2017 via Hootsuite
Govindan: EGFR mutant drugs (erlotinib) K-M curve: 10.4mos vs 5.1mos. New drug osimertinib, mut-spec, plasma comparable to tissue #PMWC17
5:54pm January 23rd 2017 via Hootsuite
Govindan: With these pts - getting biopsy is very hard. Will talk about ctDNA and Rx for EGFR mutant NSCLC; tumor het; and prognosis #PMWC17
5:52pm January 23rd 2017 via Hootsuite
Govindan: Have seen 50 nodules disappear in a week; ROS1+ NSCLC image; a few weeks almost completely cleared. #PMWC17
5:51pm January 23rd 2017 via Hootsuite
Govindan: mNSCLC before/after erlotinib: dramatic difference, in mutant EGFR mutant disease. Higher % in Asia (40%) due to smoking #PMWC17
5:50pm January 23rd 2017 via Hootsuite
Ramaswamy Govindan (WashU SOM) ctDNA in the treatment of lung cancer #PMWC17
5:49pm January 23rd 2017 via Hootsuite
Rosenfeld: Showed sensitivity data, >95% at 0.1% now. Can envision pt-specific panels to characterize changes over time during Rx #PMWC17
5:47pm January 23rd 2017 via Hootsuite
Rosenfeld: Inivata has now raised $45M series A and opened up NAm presence. Showed 10-fold increase in sensitivity #AACR15 #PMWC17
5:44pm January 23rd 2017 via Hootsuite
Rosenfeld: '12 ref of method: https://t.co/JdKeyDirMf first discovery of mutation from plasma alone - confirmed EGFR in tissue #PMWC17
5:43pm January 23rd 2017 via Hootsuite
Rosenfeld:Amplicon - for smaller panels, better sens. Hybrid capture - has experience loss of sensitivity. Their method TAm-Seq #PMWC17
5:42pm January 23rd 2017 via Hootsuite
Rosenfeld: Distinguishes PCR-based vs NGS-based methods. Shows fig from '13 ref https://t.co/FqJlQ4n3W6 and the case for monitoring #PMWC17
5:40pm January 23rd 2017 via Hootsuite
Rosenfeld: Single analyte via dPCR (high sens) up to WGS (high coverage) and in-between - targeted, and capture #PMWC17
5:37pm January 23rd 2017 via Hootsuite
Rosenfeld: Shows fig from Bettegowda STM '14 paper, illustrating spread of allele fractions, increasing w/cancer progression #PMWC17
5:36pm January 23rd 2017 via Hootsuite
Nitzan Rosenfeld (Inivata) Targeted deep sequencing of circulating tumor DNA #PMWC17
5:35pm January 23rd 2017 via Hootsuite
Morris: ctDNA is used for: Earlier Dx; select Rx; monitor disease; molecular profiling #PMWC17
5:34pm January 23rd 2017 via Hootsuite
Clive Morris (Inivata) Clinical applications of ctDNA in cancer management. Intro list of company logos (resolution bio, saga, TMO) #PMWC17
5:33pm January 23rd 2017 via Hootsuite
Pal: What happens when dirty data meets data liquidity? There has to be some kind of hygiene - to clean it up, like wastewater #PMWC17
5:31pm January 23rd 2017 via Hootsuite
Pal: Individual to device to medical record and normalized for care. Now working with Pharma for pt-oriented clinical trials #PMWC17
5:30pm January 23rd 2017 via Hootsuite
