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Cancer Genomics Coming up to Speed. NCI Cancer Center Directors April 19, 2012. NCI Cancer Genomics 2012-> 2018 . DISCOVERY by genomics and functional genomics. Pathway Function. DNA-based Diagnosis. Drug Development. Precision Treatment . Present / Future TCGA, TARGET, CTD2.

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Presentation Transcript
slide1

Cancer Genomics Coming

up to Speed

NCI Cancer Center Directors

April 19, 2012

slide2

NCI Cancer Genomics 2012-> 2018

DISCOVERY by

genomics and functional genomics

Pathway

Function

DNA-based Diagnosis

Drug Development

Precision Treatment

Present / Future TCGA, TARGET, CTD2

slide3

Cancer Genome Conclusion 1

One tumor type -> different driver genes/mutations

slide4

Conclusion 2

Many tumor types per gene, per pathway, per drug

Argues for off-label use of drugs based on genomic typing

rather than histopathological typing

slide5

Conclusion 3

Tumors are highly combinatoric for driver genes

0.7 x 0.5 x 0.3 = 0.1

Additional genetic combinatorics from

metastasis 0.5 X 0.3 = .15

treatment side effect allele 0.5

resistance 0.2 Frequency = 0.0015

>> We therefore need to learn from 105 – 107 cases

TCGA is only 500 cases of each histo-type type

NCI Cancer Centers opportunity to lead......

slide6

Clinical Cancer genomics can/should drive more and deeper discovery

Invent new patient status:

“Cancer Information Donor”

To capture shared knowledge from

those who donate de-identified genomic & clinical data

Hopeful and essential goal, but challenges to implement

Can NCI Cancer Centers be at the forefront?

slide7

Three Classes of Genome Diagnostics

1. Genome-derived specific tests: i.e. EGFR

2. “Actionable” gene panels (drivers): 10’s – 100’s

3. Full Genome-Driven Diagnosis

whole exomes

whole transcriptomes

genomes sequenced

In your centers, what to translate when, to whom,

and who learns the outcomes?

slide8

What should our immediate future be?

What do other 1st world efforts teach?

slide9

For “Genome Informed” Studies:

DNA/RNA information obtained during trials

and from archival samples

Working proposition for 2013:

Every NCI-funded trial will require genomic samples & consents

  • Made possible by FFPE sample improvement -> DNA/RNA sequencing
  • Require genomic data to be deposited in timely manner in appropriate database for entire research community
slide10

For “Genome DRIVEN” treatment

  • Genomic testing to guide treatment
    • Patients increasingly demandthis
    • Working propositions to consider / refine / replace:
    • 1. Establish minimum genome diagnostic panel (s) for all
    • NCI Cancer Center patients – revise annually
    • 2. Create and cultivate “Cancer Information Donor”
    • Apply coherent informed consent
    • Return information (de-identified) to national database
slide17

NCI Cancer Genomics

DISCOVERY by

genomics and functional genomics

Pathway

Function

DNA-based Diagnosis

Drug Development

Precision Treatment

Present / Future TCGA, TARGET, CTD2