Solid Tumors Subdivision Report
By Loren Joseph, MD
Chair, Solid Tumors Subdivision
Just this morning I had an unexpected opportunity to hear an outstanding talk by Dr. Maura Gillison, Director of Cancer Research at The Ohio State University Comprehensive Cancer Center. She is giving a talk on Saturday afternoon (Plenary Session) at the upcoming AMP Annual Meeting on her foundational work establishing HPV as a causative factor in a subset of oropharyngeal carcinoma. It is now clear that this subset shows distinctive clinical behavior, presenting clinicians with a difficult dilemma in choosing therapy. Positivity for p16 by immunohistochemistry is probably the commonest way of inferring the presence of HPV, a lacunae enterprising AMP members might correct. If you are not familiar with this topic, try to make the talk. If you are familiar, come to learn the latest.
Katherine Geiersbach, Subdivision member of the Website Editorial Board, notes that she is still taking submissions for the AMP Solid Tumor Reviews - check the KRAS review for an example/template - any submissions would be greatly appreciated. These topics are already spoken for: MSI testing and ALK FISH in non-small cell lung carcinoma (NSCLC). Any other topic is welcome.
Neal Lindeman and Federico Monzon, Subdivision representatives to the Clinical Practice Committee, provides an update on current projects:
- Review the utilization of MGMT methylation testing for gliomas and determine the clinical need and technical recommendations for this testing in clinical practice. This started in August. The team consists of AMP members Marina Nikiforova, Iris Schrijver, Adekunle Adesina, and Neal Lindeman, as well as neuro-oncologist Patrick Wen (Massachusetts General Hospital) and neuropathologist Kenneth Aldape (M.D. Anderson Cancer Center).
- Establish guidelines for molecular testing in lung cancer. This will be integrated with similar ongoing projects by the College of America Pathologists (CAP) and International Association for the Society of Lung Cancer (IASLC) as a joint effort.
- Formation of a KRAS working group to develop guidelines for KRAS testing. Once a well rounded draft is done, the Clinical Practice Committee (CPC) will approach the CAP and American Society of Clinical Oncology (ASCO) for comments and possible co-publication.
- Bill Funkhouser is preparing a review manuscript on the effect of fixation on RNA/DNA assays.
Jennifer Laudadio and Tina Edmonston, Subdivision representatives to the Training and Education Committee (T&E), highlight the outreach course for emerging molecular pathologists immediately preceding the Annual Meeting. The course will include a presentation on molecular solid tumor testing by Jennifer Hunt. Case presentations will also be given by T&E Committee members. The next Solid Tumor related webinar will be in December and will cover genomic arrays in pediatric oncology. Planning is underway for the 2011 webinar series.
Solid Tumors Subdivision at the Annual Meeting
Joe Gray will present a Plenary Session entitled "Genomic approaches to predictive and prognostic markers in breast cancer." Stefanie Jeffrey will present a Plenary Session entitled "Single cell analysis of circulating tumor cells in cancer." Thomas Stricker will present a Workshop on transcriptomics in breast cancer. Marina Nikiforova will give a Workshop on molecular diagnostic testing for IDH1 and IDH2 mutations. Marina Nikiforova will moderate an Early Bird Session on challenging cases in Solid Tumors.
Some of many articles of interest
During the planning for the Annual Meeting I asked Karl Voelkerding, who was assembling an expert panel on Next Gen Sequencing, if there was anyone who could talk about application to FFPE (formalin-fixed paraffin-embedded) tissue. There were no takers at the time but two papers have been published in the interim which partially address this topic: Nucleic Acids Research 38(41):e151 and PloS One 5(1):e8768 . Not to ruin the suspense, but neither report describes Whole Genome Sequencing (WGS). Even if WGS is feasible, routine procurement of fresh frozen might be the best strategy. Whether or not whole genome sequencing/transcriptomics will prove important for Solid Tumor Diagnostics (as opposed to targeted analysis) will be a cheerfully contentious issue until exabytes (zettabytes, or maybe even yottabytes) of data are analyzed.