NGS用于指导晚期恶性肿瘤治疗.pptx

NGS用于指导晚期恶性肿瘤治疗新进展----精准检测，精准治疗Insight on Novel Mechanisms and Precision Care ;基因检测一览;Presented By Claudine Isaacs at 2016 ASCO Annual Meeting;Sequencing is …;近8年，ASCO年会上与NGS相关的摘要数目投稿;内容： NGS指导下EGFR突变型TKI 耐药患者的治疗 NGS指导下的肿瘤免疫治疗 cfDNA检测与肿瘤治疗 NGS在多种实体肿瘤治疗中的应用;肿瘤异质性;EGFR-TKI耐药机制 EGFR-TKI原发性耐药机制 EGFR-TKI获得性耐药机制    ;EGFR-TKI原发性耐药机制;TKI获得性耐药的临床定义;EGFR-TKI获得性耐药的可能机制;获得性耐药患者的管理策略？;三种临床失败模式;EGFR-TKI获得性耐药的治疗策略单纯局部治疗;Politi K, et al. Clin Cancer Res. 2015 May 15;21(10):2213-20. ;不同失败模式的生存分析;病例;2016-1-27 CT引导下肺肿物穿刺活检;NGS测序结果;2016-1-16;2016-4-1;小结：EGFR-TKI获得性耐药的治疗策略;;内容： NGS指导下EGFR突变型TKI 耐药患者的治疗 NGS指导下的肿瘤免疫治疗 cfDNA检测与肿瘤治疗 NGS在多种实体肿瘤治疗中的应用;Cancer is a disease of …;Presented By Douglas Johnson at 2016 ASCO Annual Meeting;Introduction;Candidate biomarkers for anti-PD-1/PD-L1;Aims;Methods;Mutation load and response;Mutation load and response;Mutation load and response;Mutation load and survival;Specific mutations;Specific mutations;Mutation load comparisons;Mutation load and survival in unselected patients;TCR clonality;Potential implications;Conclusions;正在进行的工作：;内容： NGS指导下EGFR突变型TKI 耐药患者的治疗 NGS指导下的肿瘤免疫治疗 cfDNA检测与肿瘤治疗 NGS在多种实体肿瘤治疗中的应用;ctDNA PPV vs. tissue biopsy (NSCLC, CRC, Breast, Others);Serial Next Generation Sequencing (NGS) of cell free DNA (cfDNA) reveals clonal evolution of AKT1 E17K mutant tumors: analyses from patients enrolled on a phase I basket study of an AKT inhibitor (AZD5363) ;Background – Targetable Driver Oncogenes;Background- Liquid biopsies;Background- Liquid biopsies;Objectives;Study design;Study Schema ;Sample Collection;Patient demographics;br /AKT1 E17K detected and monitored in cfDNA by ddPCR;AKT1 mutant allele fraction (MAF) in cfDNA highly concordant between ddPCR and NGS;NGS of Pre-treatment cfDNA (n=25) captured tumor heterogeneity;Slide 13;NGS of Longitudinal cfDNA (n=23) detected new mutations during disease progression;NGS of Longitudinal cfDNA (n=23) revealed clonal evolution;Pre-treatment cfDNA captured