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Sample Acquisition With Annotated Clinical Information
1. Sample Acquisition With
Annotated Clinical Information
A Critical Success Factor In Biomarker Validation
TriStar
Technology Group
9700 Great Seneca Highway, suite 401
Rockville, MD 20850
(E) info@tristargroup.us
(P) 301-792-633
(W) www.tristargroup.us
2. the need for targeted therapeutics
with companion diagnostics
Development of targeted therapeutics requires testing in targeted populations
matched to a drug’s mechanism of action
Evaluation of Trastuzamab in “all comer” breast cancer patients (25% HER+,
75% HER2-) would not have shown significant benefit in clinical trials
Early proof of concept in the right patient population is crucial
Potentially shorter time to market
3. An emerging unmet need in oncology drug
development today is service providers
that offer both access to well-annotated
specimens and sophisticated molecular
analytical capabilities
4. Rockville, MD Hamburg, Germany
TMA Repository
Array Manufacturing
Contract Research
Madrid, Spain Rome & Catania, Italy
TMA Repository TMA Repository & Contract Research
Cancer Stem Cell Research
5. tristar provides
Access to 2.5 million archived samples & clinical data
Access to patients (prospective collection projects)
Fit-for-purpose analytical platforms & services (IHC, FISH, qRT-
PCR etc.)
Collaboration for Solid tissue biomarker development
6. ethical considerations
Informed Donor Consent
IRB/EC Approval
Fully Anonymized
Compliant with Current International & EU Regulations
Blocks That Are in Excess of Diagnostic Sample Only
Team of 17 Pathologists & 5 Oncologists for Clinical Data Review
7. product groups
Archived Human Tissue Repository
>2.5 million samples (FFPE & Frozen). 70% Oncology, 30% CNS, GI etc.
High-Density Tissue Micro Arrays
>100,000 donor samples with outcome data
Outcome Data
Treatment, Response rates, disease –free survival (DFS), overall survival (OS)
Molecular Data
ER/PR/HER2, p53, BRAF, KRAS, EGFR, PIK3CA etc.
Blocks & Large sections
With matching RNA, DNA
Cancer Stem Cell Arrays
Lysates & RNA
8. our services
Protein Expression
IHC (Antibody protocol development, automated or manual staining, reading & interpretation)
Large-Scale Analysis of Prognostic markers (500-3500 donor samples)
(500-3500 donor samples)
Gene Expression
RT-PCR
Gene copy number
FISH/CISH
Gene sequencing
DNA sequencing
Cross-Reactivity Screening in Normal Tissue
(GLP)
9. quality control
Samples are fixed/frozen within 2 – 10 minutes of
Excision
OCT embedded sample
Snap frozen sample
Formalin fixed sample
10. quality control
10% Buffered formalin, 10-12 hrs. fixation time
Morphology (H&E) & IHC Markers for
immunogenicity
RNA & DNA Quality (Agilent 2100 Bioanalyzer)
RIN can be checked & provided upon request
11. primary tumors
with matched mets
Primary Tumors Matched Mets Approximate number
Nodal 2000
Breast Distant 20
Bone 200
CRC Nodal 2000
Liver 150
Prostate Nodal 500
Bone 300
Lung (NSCLC) Nodal 300
Bone 100
Pancreatic Nodal 100
Head & Neck Nodal/Soft tissue 100
Gastric Nodal, liver etc 200
Melanoma Nodal 50
12. samples with outcome data
tumor type data approximate number
5 yr survival 5000
Breast 10 yr. survival 300
Herceptin 400 (responders & non-responders)
3-5 yr survival 4000
CRC
Bevacizumab, Cetuximab 500 (responders & non-responders)
Prostate, 10 yr survival 5000
Breast, CRC, Ovarian SOC Chemotherapy 1500 (responders & non-responders)
3-5 yr survival 2000
Lung (NSCLC)
Docetaxel, Gemcitabine 400
Pancreatic Survival 350
Head & Neck Treatment/survival 200
Gastric Survival 250
NHL Survival 200
Ovarian 3-5 yr. survival 300
Bladder Survival 500
13. tissue microarrays
Morphology
Formalin Fixed
Paraffin Embedded
RNA/Protein/DNA
Frozen OCT Embedded DNA
14. tissue microarrays to study tumor
heterogeneity
The whole tumor is sectioned Cores are taken from each constituent tumor
into 8-10 constituent blocks block and transferred to a TMA.
The exact localization of each
block is recorded
15. tissue microarrays to study tumor
heterogeneity
An optimal way to measure intratumoral heterogeneity
Allows for an overview of the whole tumor
Matched Nodal Total number of
Tumor Type Primary tumors Blocks per tumor Blocks per met
Mets TMA Cores
NSCLC 146 8 66 4 1432
Breast 147 8 32 4 1304
CRC 140 8 42 4 1288
Prostate 190 10 - - 1900
Bladder 147 8 - - 1176
16. EGFR amplification is often
heterogeneous in lung cancer
Heterogeneity found in 7/13 (54%) EGFR amplified NSCLC
Different areas Different matched
of the primary cancer lymph node metastases
Case
#1
EGFR FISH Result
#2
#3 amplification
#4 polysomy
#5
normal
#6
#7 n.a.
17. heterogeneity TMA: co-analysis of ERG and
PTEN in prostate cancer
35 ERG+PTEN
10 PTEN only
4 ERG only
PTEN linked to ERG
31 tumors PTEN+ERG
21 ERG precedes PTEN
0 PTEN precedes
PTEN deletions are late events developing ERG earlier
preferentially in ERG positive prostate
cancers PTEN + ERG
PTEN only
ERG only
P<p<0.0001
18. prostate cancer progression &
prognosis analysis
Frequency of PTEN deletion is strongly linked to prostate cancer
progression (n >2200 donor samples)
50.0 p<0.0001
45.0
40.0
fraction of tumors (%)
35.0 PTEN homozygous
30.0
25.0 PTEN hemizygous
20.0
15.0
10.0
5.0
0.0
PIN (n=29) BPH (n=20) pT2 pT3a pT3b pT4 (n=24) HR (n=54)
(n=1085) (n=360) (n=227)
19. tissue micro arrays to study
tumor heterogeneity
The level of heterogeneity of therapy target genes may be relevant for
diagnosis and response
HER2 is homogenous in breast cancer but heterogeneous in colon cancer
Tumor heterogeneity is clinically important and can be optimally addressed
by heterogeneity TMAs
20. molecular epidemiology
Most oncology drugs in development are expected to be active only
in sub-sets of patients
How frequent is expression in human cancer?
Specific cancer subtypes or biological properties?
-prognostic relevance
What normal tissues do express target?
Option 1: Option 2:
Review the Perform
literature own studies
21. TriStar: a new dimension in
tissue biomarker analysis
Prognosis TMA-Based Target Evaluation Strategy (IHC)
Multi-Tumor Tissue Array Normal Tissue Array Tumor Cell Line Array
3,500 donor samples 600 donor samples 140 Cell Lines
All Cancer Types 532 Cell Types Including NCI 60
√ Expression in cancer types (including niche cancers)
√ Complete normal tissue expression information
√ Cell lines identified for functional studies/drug screening
Cancer – Specific Prognosis TMA Analaysis
Prostate Cancer Breast Cancer Lung Cancer Bladder Cancer
(3,000 donors) (2,000 donors) (1,400 donors) (1,100 donors)
Colon Cancer Pancreatic Cancer Ovarian Cancer NHL
(1,400 donors) (300 donors) (200 donors) (200 donors)
Relationship of Molecular Target to Prognosis, Histological Sub-type,
Response to Treatment etc
23. HER2 Expression and Amplification
in Human Cancers
Tapia et al., Modern Pathology, 20(2), 192–198 (2007)
IHC FISH
Urinary bladder cancer
Pancreatic cancer
Endometrial cancer
Gall bladder cancer
Ovarian cancer
0.0 5.0 10.0 15.0 20.0
Fraction of HER2-amplified samples (%)
33. study: sequencing of all 10 PTEN exons in
100 prostate cancer samples
a) c.1067_1070del c) c.1623G>T e) c.352C>T
G C AG AAAC AAAAG G GATGTTTGAAACTAT GCTTTGTCAAGATCA
b) c.2007G>A d) c.1981_1984del
- 5% Mutations
GCAACATGATTGTCA TAAAGTAAGTACTAG
- Mutation Unrelated To Deletion
ABI3100, 16 capillaries tumor type data approx. # p value
Eppendorf pipetting robot PTEN not deleted 95.4% 4.6% 0.3096*
Laser capture micro dissection
(if necessary) PTEN hemizygous
deleted 17 11.8%
UKE data FISH not analyzable 18 0.0%
34. sample data fields
Breast Cancer with Herceptin Treatment & Response Information
LOCALISATION REF# ORGAN UNIQUE ID AGE DATE OF SURGERY DIAGNOSIS
METS POST SURGERY
GRADE T N M (TIME 0) STAGE HER2 ER (%) PR (%) SITE OF MET. METS DIAGNOSIS BY
(MONTHS)
PREV. START TREAT 1 END START TREAT 2 FOLLOW UP
SETTING END TREAT 2 FOLLOW UP 1 FOLLOW UP 2 SURVIVAL
CHEMOTH. TREAT 1 DETAILS TREAT 1 TREAT 2 DETAILS 3
35. sample prospective
collection projects
Prospective collection of formalin fixed samples of mantle cell lymphoma from
lymph node sites only with 5-10ug matching RNA per sample
Prospective collection of Frozen OCT & FFPE samples of IBD & Ulcerative Colitis,
recently diagnosed, diseased + adjacent normal. Matched Serum & Whole Blood
with Clinical Labs
Prospective collection of formalin fixed & OCT samples of metastatic NSCLC
(adenocarcinoma & SCC) with matched nodal mets, serum & RNA
Prospective collection of formalin fixed & OCT samples of esophageal
adenocarcinoma, serum & RNA
36. overview
Complexity of translational biomarker research supporting drug & diagnostic
development increasingly requires knowledge-based services/partnerships that
go beyond the traditional fee-for-service model
Service providers must offer a range of services, histology labs, analytical
platforms, top academic opinion leaders etc.
TriStar’s service platform is sustainable, scalable, flexible & cost-effective
Very large product offering, standardized QC, top-notch scientific capabilities
37. contact us
TriStar Technology Group LLC
9700 Great Seneca Highway
Rockville, MD 20852
For more information please visit our
website at www.tristargroup.us
p. 1-866-851-STAR
f. 1-509-471-1765
e. info@tristargroup.us
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