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The Center for Personalized Diagnostics: Past, Present, and FUTURE ALL in for ALL Patients: A Campaign for the CPD Campaign Goals: Sequence every ACC patient’s DNA Find more mutations Build out biobanks Make information accessible to all physicians Center for Personalized Diagnostics: Lung Cancer 11% of patients analyzed by the CPD have been Lung Cancer Patients. The CPD tests tumor tissue for mutations relevant for immediate treatment and those that indicate possible resistance. More Actionable Mutations Found Improved Targeted Therapies EGFR ALK ROS1 ERBB2 BRAF PIK3CA And more to be discovered What’s in Store for the Future: Next Generation Tests LUNG CANCER TARGETS Better Clinical Outcomes Center for Personalized Diagnostics: GI Cancer 10.5% of patients analyzed by the CPD have been GI Cancer Patients. GI CANCER TARGETS The CPD is currently testing tumors for mutations that help find targeted therapies KRAS EGFR BRCA CKIT BRAF And more to be discovered What’s in Store for the Future: Next Generation Tests More Actionable Mutations Found Improved Combined Targeted Therapies More Clinical Trial Options Center for Personalized Diagnostics: Brain Cancer 7.0% of patients analyzed by the CPD are Brain/CNS Cancer Patients. The CPD tests for mutations with targetable treatments, as well as mutations that help establish the patient’s diagnosis. What’s in Store for the Future: Next Generation Tests More Actionable Mutations Found Improved Targeted Therapies More Clinical Trial Options BRAIN CANCER TARGETS EGFR ATRX BRAF IDH1/2 And more to be discovered Center for Personalized Diagnostics: Myeloid Leukemia 2.8% of patients analyzed by the CPD Are Acute Myeloid Cancer Patients The CPD tests for mutations that have prognostic, therapeutic, relapse, and monitoring implications. What’s in Store for the Future: Next Generation Tests More Actionable Mutations Found Improved Targeted Therapies More Clinical Trial Options MYELOID TARGETS TP53 FLT3 PTEN NPM1 DNMT3a CKIT JAK2 And more to be discovered Center for Personalized Diagnostics: CLL, MM, and Lymphoma Current broad CPD panel to evaluate for CLL, MM, and Lymphoma Cancer Patients. LYMPHOMA TARGETS The CPD needs to create specific, discrete panels for CLL, MM and Lymphoma. What is the status on CLL and MM tests/targets? What are the prognostic, therapeutic, relapse, and/or monitoring implications of mutation discovery? What’s in Store for the Future: Next Generation Tests More Actionable Mutations Found Improved Targeted Therapies More Clinical Trial Options TP53 PIK3CA PTEN BTK PLCG2 MYD88 BRAF JAK1/3 STAT3/5 And more to be discovered Center for Personalized Diagnostics: Breast Cancer 12.7% of patients analyzed by the CPD have been Breast Cancer patients. What is the status on breast cancer tests/targets? What are the prognostic, therapeutic, relapse, and/or monitoring implications of mutation discovery? What’s in Store for the Future: Next Generation Tests More Actionable Mutations Found Improved Targeted Therapies More Clinical Trial Options BREAST CANCER TARGETS erbB, BRCA1/2, MET AKT1/2/3 CDKN2A MDM2 PDGFRA And more to be discovered Center for Personalized Diagnostics: Ovarian Cancer Only 1% of patients analyzed by the CPD have been ovarian Cancer Patients. What is the status on ovarian cancer tests/targets? What are the prognostic, therapeutic, relapse, and/or monitoring implications of mutation discovery? What’s in Store for the Future: Next Generation Tests More Actionable Mutations Found Improved Targeted Therapies More Clinical Trial Options OVARIAN CANCER TARGETS BRCA1/2, RET AKT1/2/3 CDKN2A MDM2 PDGFRA And more to be discovered Center for Personalized Diagnostics: BRCA 40% of patients on which BRCA1/2 testing was done by the CPD showed disease-associated mutations - 25% of breast cancers tested - 55% of GI cancers tested How is the CPD utilizing BRCA mutation across different cancer types? What are the prognostic, therapeutic, relapse, and/or monitoring implications of mutation discovery? What’s in Store for the Future: Next Generation Tests More Actionable Mutations Found Improved Targeted Therapies More Clinical Trial Options BRCA CANCERS Breast Ovarian Pancreatic GI Center for Personalized Diagnostics: Melanoma 11.4% of patients analyzed by the CPD have been Melanoma Patients. What is the status on melanoma tests/targets? What are the prognostic, therapeutic, relapse, and/or monitoring implications of mutation discovery? What’s in Store for the Future: Next Generation Tests More Actionable Mutations Found Improved Targeted Therapies More Clinical Trial Options MELANOMA TARGETS BRAF PTEN NRAS NF1 PIK3CA TERT And more to be discovered Center for Personalized Diagnostics: Sarcoma Less than 1% of patients analyzed by the CPD have been Sarcoma Patients. What is the status on sarcoma tests/targets? What are the prognostic, therapeutic, relapse, and/or monitoring implications of mutation discovery? More Actionable Mutations Found Improved Targeted Therapies MET PIK3CA PTPRD TP53 PDGFRA FOXO1-PAX3/7 And more to be discovered What’s in Store for the Future: Next Generation Tests SARCOMA TARGETS More Clinical Trial Options Center for Personalized Diagnostics: GU Cancers 17.0% of patients analyzed by the CPD have been GU Cancer Patients. What is the status on GU tests/targets? GU TARGETS TERT FGFR3 What are the prognostic, therapeutic, relapse, and/or monitoring implications of mutation discovery? What’s in Store for the Future: Next Generation Tests More Actionable Mutations Found Improved Targeted Therapies More Clinical Trial Options RAS PIK3CA And more to be discovered Center for Personalized Diagnostics: Head and Neck Cancers 6% of patients analyzed by the CPD have been Head and Neck Cancer Patients. What is the status on Head and Neck cancer Tests/targets? What are the prognostic, therapeutic, relapse, and/or monitoring implications of mutation discovery? What’s in Store for the Future: Next Generation Tests More Actionable Mutations Found Improved Targeted Therapies More Clinical Trial Options HEAD AND NECK TARGETS EGFR BRAF KRAS PIK3CA And more to be discovered Center for Personalized Diagnostics: Neuroendocrine tumors (NETs) 1.5% of patients analyzed by the CPD have been NETs Patients. What is the status on NETs tests/targets? NET Cancer TARGETS What are the prognostic, therapeutic, relapse, and/or monitoring implications of mutation discovery? What’s in Store for the Future: Next Generation Tests More Actionable Mutations Found Improved Targeted Therapies More Clinical Trial Options ATRX MEN1 ASCL1 TP53 MTOR PIK3CA And more to be discovered Center for Personalized Diagnostics: Thyroid Cancer 7.3% of patients analyzed by the CPD have been Thyroid Cancer Patients. What is the status on thyroid tests/targets? How is the CPD partnering with the Center for Rare Cancers and Personalized Therapy? What are the prognostic, therapeutic, relapse, and/or monitoring implications of mutation discovery? What’s in Store for the Future: Next Generation Tests More Actionable Mutations Found Improved Targeted Therapies More Clinical Trial Options THYROID TARGETS BRAF RET ALK PIK3CA, NTRK1/3 TP53 And more to be discovered Center for Personalized Diagnostics: Cutaneous T cell Lymphoma (CTCL) 0 % of patients analyzed by the CPD have Been CTCL Patients. What is the status on CTCL tests/targets? What are the prognostic, therapeutic, relapse, and/or monitoring implications of mutation discovery? What’s in Store for the Future: Next Generation Tests More Actionable Mutations Found Improved Targeted Therapies More Clinical Trial Options CTCL TARGETS JAK1/3 STAT3/5 TYK2 TP53 BRAF PLCG2 PTEN And more to be discovered The Future of the CPD Advance current technology to better locate mutations and understand how mutations work together Build technology to detect Circulating Tumor Cells Coordination of tissue procurement New sequencing equipment Automation of work flow Enhance bioinformatic support Integration of laboratory information system with EPIC Develop testing platforms to detect circulating tumor DNA for all solid tumors Resources to recruit, educate, train, and retain bioinformatics experts Establish training programs in computational personalized diagnostics Recruit additional scientists in bioinformatics and computational diagnostics