Cancer is characterized by the accumulation of mutations that lead to uncontrolled cell growth; much of precision medicine is based on identifying causative mutations and the use of therapies that target them. Variation in disease development, progression, and response to therapies suggest that, beyond simple mutations, complex regulatory processes are at play. We will show how gene regulatory network inference can identify what truly drives disease and identify candidate therapies.

An essential component of precision medicine in childhood cancer is to determine whether a patient has an underlying genetic predisposition to cancer. Such findings may inform selection of therapy, increase the risk for second tumors, and have implications for the family if the gene alterations are inherited from a parent. This talk will highlight current integrated molecular approaches employed to identify alterations in cancer risk genes in pediatric patients with solid tumors.

The Somatic Reference Sample initiative is a public-private partnership guiding the development of reference samples that can be used to develop and validate NGS-based oncologic tests. Ensuring that oncology patients receive accurate results is imperative; however, lack of agreed upon well-characterized and community-validated reference samples and data benchmarks creates potential challenges for efficient development of these tests and for understanding their results. Hear an update on this transformative initiative.

Sequencing advances have revealed most genetic variants in bladder cancer yet patient response rates to therapeutics directed at such variants have been suboptimal. This is partly because of tumor heterogeneity with cells harboring diverse variant profiles. Recent advances in single-cell omics allow direct examination of heterogeneity in human tumors and determine the proportion of cells with specific alterations. This technology also allows a better understanding of the tumor microenvironment and its non-malignant components. This presentation focuses on recent advances in understanding tumor heterogeneity using single-cell omics in bladder cancer and highlighting the therapeutic implications of such knowledge.

The Molecular Disease Characterization Initiative (MDCI) is an innovative study design that collects a comprehensive baseline assessment (tumor and blood) of disease and leverages data to screen against multiple trial options, across different therapeutic modalities. This study creates a platform to accelerate the availability of new therapeutic options for patients through matched investigative and precision medicine clinical trials, while building a scientific database to facilitate the investigation of biological mechanisms.

Applying pharmacogenomics to patient care in oncology has the ability to improve patient safety and disease outcomes. In this session, important drug/gene pairs will be reviewed, practical tips from live implementations will be shared, as well as real-world data pharmacogenomics data. Attendees should gain a better understanding of the possible impact of pharmacogenomics for their patients and how to tackle some implementation challenges.

The vast complexities of cancer are characterized by heterogeneity across samples, from tumor cells and tumor microenvironments to therapeutic responses. Through innovations in single cell sequencing and spatial transcriptomics, 10x Genomics helps researchers investigate the body’s response to tumors, discover tumor-associated mutations, and uncover mechanisms of acquired resistance to therapy. Join us to learn how researchers are using our single cell and spatial tools to gain a multidimensional view of cancer.

Prolonged suppression of androgen receptor signaling in prostate cancer has led to an increase in lineage plasticity, wherein the tumor transitions from a classical, androgen receptor (AR)-positive, prostate-specific antigen (PSA)-expressing adenocarcinoma to an AR-low/negative, PSA-low tumor with an undifferentiated or neuroendocrine (NE)/small cell histology. Clinical trials in this population have been hindered by inconsistent and vague eligibility criteria that underrepresent the molecular and phenotypic diversity.  Here we focus on the development of liquid biopsy assays to identify actionable targets that enable precision medicine to improve patient outcomes.

This presentation will discuss novel biomarkers for cancer immunotherapy including host effects influencing the immune response such as the microbiome.

Transformative precision medicine approaches perfectly integrate disease root cause identification, prediction of disease dynamics and medical interventions guided by an advanced understanding of pharmacodynamic up- and downstream effects which allows to optimize and deepen responses at individual patient level. AI/ML powered translational research generated several clinically actionable insights for new targets, early interventions/maintenance settings and combination therapies. Digital pathology, radiomics and advanced clinical genomics platform approaches are key enablers to develop precision oncology break-through therapies.

Circulating exosomes have emerged as means for a multitude of cancer applications including early detection, tumor molecular classification, prediction of therapeutic response, and monitoring of tumor progression and regression. The informative value of circulating exosomes across several types of solid tumors will be presented that are indicative of the value of circulating exosomes as a liquid biopsy approach.

We have developed a functional genomics engine that consists of a multi-interdisciplinary team of clinicians, pathologists and scientists, utilizing the latest comprehensive genomics tools and preclinical models dedicated to improving patient outcomes by tailoring therapy according to the compendium of alterations of the patient’s cancer. Knowledge that is gained by this system leads to novel biomarkers that if validated can be translated to clinical tests in a CLIA environment.