Presentation on theme: "Diagnostic Capabilities Beyond the Tumor Cell Genome Gregory J. Tsongalis, PhD, HCLD Professor of Pathology Director, Molecular Pathology Geisel School."— Presentation transcript:
Diagnostic Capabilities Beyond the Tumor Cell Genome Gregory J. Tsongalis, PhD, HCLD Professor of Pathology Director, Molecular Pathology Geisel School of Medicine at Dartmouth Dartmouth Hitchcock Medical Center Norris Cotton Cancer Center Lebanon, NH
Outline Technology and Personalized Medicine miRNAs The liquid biopsy Beyond that…….
Technology and Therapeutics as Drivers of Medical Care Basic Science Clinical Medicine Translational Research Clinical Laboratory Medicine TherapeuticsTechnology
The Genome Or The Human Karyotype
Massively Parallel or Next Generation Sequencing at DHMC MiSeq PGM Sequence by Synthesis
Personalized Medicine Shaw A T and Engelman J A JCO 2013;31: (A) Before crizotinib; (B) after 7 weeks of crizotinib.
Nucleus Cytoplasm Pri-miRNA Pre-miRNA miRNA:miR NA* duplex Unwinding Drosha DGCR8 Exportin 5 Dicer RISC Ribosome Translational Repression mRNA Cleavage C. L. Bartels and G.J. Tsongalis, Clin Chem, 2009;55: Specificity (miRNAs as Biomarkers)
Issues With The Tissues –Tumor tissue has inherent limitations –Tumor tissue is a single snapshot in time –Selection bias due to tumor heterogeneity –Invasive procedure
Resected SpecimenSmall Needle Core Biopsy Exhausted Block A Huge Problem
The Liquid Biopsy Cell Free DNA (cfDNA) –Cells undergoing apoptosis or necrosis –Amount of cfDNA correlates with tumor staging and prognosis
Xenograft Model Kerrington Smith, MD
J. E. Hill, PhD Thayer School of Engineering at Dartmouth Breath-based Diagnostics
Conclusions Circulating nucleic acids become future biomarkers of choice More advanced analysis of simpler specimens
Molecular Pathology Laboratory and Translational Research Program Samantha Allen Paul Burchard Francine de Abreu, Ph.D. Leanne Cook Betty Dokus Amber Erskine Torrey Gallagher Arnold Hawk Joel Lefferts, Ph.D. Emmeline Liu Rebecca O’Meara Jason Peterson Elizabeth Reader Barbara Soares Heather Steinmetz Laura Tafe, M.D. Scott Turner, PhD Wendy Wells, M.D. Terri Wilson Eric York