LSUHSC-Shreveport, Louisiana

Molecular Pathology News

Dr Nordberg was an invited speaker at the 2010 AACC Annual Meeting

American Society for Clinical Laboratory Science 78th Annual Meeting Anaheim, CA July 27-31, 2010

Download the audio for Session : ASCLS1042
27: New Frontiers in Molecular Medicine— Pharmacogenomic Applications in Clinical Practice

Dr. Mary Nordberg was an invited speaker for both the 2010 AACC Annual Meeting and companion meeting, the American Society for Clinical Laboratory  Science (ASCLS) in Anaheim, California.   A record breaking number of booths on the floor (over 1970+) and the exhibit floor were busy and vibrant. 

AACC is an international scientific/medical society of clinical laboratory professionals, physicians, research scientists and other individuals involved with clinical chemistry and related disciplines. The American Society for Clinical Laboratory Science (ASCLS), as the preeminent organization for clinical laboratory science practitioners, provides dynamic leadership and vigorously promotes all aspects of clinical laboratory science practice, education and management to ensure excellent, accessible cost-effective laboratory services for the consumers of health care.

Dr. Nordberg gave several separate presentations at the meetings.  At AACC, her talk was entitled 
“Cancer Pathways and the Relevance to Cancer Therapy”.  She was one in a panel of speakers addressing the role of KRAS and BRAF mutations in patients with colorectal cancer and their impact on therapeutic regimens.

At the ASCLS meeting Dr. Nordberg was selected to give several presentations:

  • Molecular Aspects of Hematology Covering JAK2V617F and Other Mutations in Myeloproliferative Diseases – Part 1
  • Molecular Aspects of Hematology Covering Genetic Abnormalities in Myelodysplasias and Acute Leukemia (Part 2)

AACC’s vision is to provide leadership in advancing the practice and profession of clinical laboratory science and its application to health care.   AACC offers many programs that address the scientific, clinical, technical, and management challenges facing laboratory professionals.   AACC spearheaded the development of Lab Tests Online, a unique consumer education program, with the cooperation of a number of professional societies and industry sponsors.  As a member of the Lab Tests Online Editorial Board, Dr. Nordberg stays up-to-date on all issues relevant to molecular genetic pathology testing. 

Dr. Nordberg selected as Chairman of the Institutional Review Board (IRB)

Recently, Dr. Nordberg was selected as Chairman of the Institutional Review Board (IRB).  All research conducted by any individual (faculty, staff, or student) under the auspices of LSUHSC-S, irrespective of the risks, scope, funding, or location of the research, must comply with federal regulations and LSUHSC-S policies for the protection of human subjects. It is the shared responsibility of this institution, the Human Research Protections Program, Institutional Review Board, Departmental Chairs, investigators and all others engaged in research to ensure that all LSUHSC-S  research activities meet these requirements. Dr. Nordberg presides over Committee #1 which deals with research predominantly involving oncology -based research and treatment protocols.

Dr. Jon Wilson is joining the Molecular Pathology lab

Following his anatomic pathology residency training at NIH, Jon completed fellowships in cytopathology (NIH), oncologic pathology (MSKCC) and neuropathology (Stanford).  He subsequently practiced neuropathology and surgical pathology for nine years at William Beaumont Hospital (Royal Oak, Michigan), and most recently finished a molecular pathology fellowship at the University of Minnesota.  His interests include neuropathology, muscle and nerve pathology, molecular pathology, soft tissue and bone tumors.  He is currently boarded in neuropathology and anatomic pathology, and board eligible for molecular pathology.

Sherry Martin, MHS, MT(ASCP), is retiring.

As June ends, so does the end of an era for the Molecular Pathology laboratory. Long-time employee, Sherry Martin, MHS, MT(ASCP), is retiring after working in the section for more than 10 years. Sherry came to the lab shortly after its initiation and has been a leading member in all aspects of clinical testing that Molecular Pathology offers. Additionally, Sherry has been a strong mentor in most of the translational research projects initiated by high school students (such as Ashley McHugh below), college students, medical students, residents, fellows, and staff. Sherry's commitment to student training reveal the true meaning of "paying it forward". Sherry's expertise in fluorescence in situ hybridization (FISH) testing is unfathomable. We want to all thank Sherry for her many years of service at LSUHSC-S. We wish her well in her future endeavors. She will be sorely missed in the laboratory.

 

Molecular Pathology Star Student, Ashley McHughAshley McHugh

Thanks to some hard work by the staff of Molecular Pathology, testing for KRAS and BRAF mutations in patients with colorectal cancer is in the final stages of validation and clinical implementation. Much of the background work for this assay was done by Ashley McHugh, a recent graduate of Caddo Magnet High School.

As part of her research project for the Science and Medicine Academic Research (SMART) Program at LSUHSC-S, Ashley worked hard to investigate both the incidence and impact of KRAS and BRAF mutations in our patient population. The work has been presented in several regional Science Fair venues, as well as submitted for presentation at the 2010 Association for Molecular Pathology annual meeting in San Jose, California and the 2010 American Association for Clinical Chemistry Annual Meeting in Anaheim, California.

As KRAS testing becomes part of standard clinical practice in guiding treatment for colorectal cancer patients, we at LSUHSC-S Molecular Pathology feel confident that our approach and use of this assay will be our latest commitment in providing quality service for our patients and clients.

The Shreveport LSUHSC team supports Louisiana State University, our regional hospitals, and national healthcare providers with a total package of professional laboratory services at the forefront of technological advancement.

As a leader in the academic world, we train medical students and fellow clinicians in the diagnostic use and implementation of all of the tests we perform. Our technical expertise and personal interest in your results enables you to determine the best patient care strategy. We have the resources and training to get test results and a professional test consult to you as soon as possible.

 

Dr Nordberg's latest speaking event

Thursday, April 29, 2010
Molecular Diagnostics for Community Hospital Laboratories

"Doing It Right when Establishing New Molecular Tests in your Hospital or Pathology Laboratory"

Mary Lowery-Nordberg, Ph.D., Director, Molecular Pathology and Cancer Cytogentics, LSU Health Sciences Center, Shreveport, LA

The big story in 2010 is Congressional Health Reform. The Executive War College is your timely first opportunity to get the inside scoop on how legislation will affect clinical laboratory testing and anatomic pathology professional services.

You’ll also experience more than 70 speakers, topics, and sessions that cover the A-to-Z of laboratory strategy, operations, and management. Check out the special sessions below!

 

Laboratory and Pathology Mergers & Acquisitions!

       Special four-hour session on Tuesday, April 27

                • Review of transactions, prices paid, valuations

                • Roundtable of laboratory and pathology group sellers

                • New legal, compliance, business issues surfacing in lab sales

                • Best hospital strategies for profitable lab outreach

                • Roundtable of laboratory and pathology group buyers

Click Here for speakers, topics and times!

 

Disruptive Technologies in Histology and Digital Pathology

       Optional Post-Event Day on Thursday, April 29

                • Case Studies by histology labs using automation and Lean

                • Experts on breakthroughs and new uses of digital pathology

                • Sessions conducted by leading histology automation solutions

                • 2-hour exhibition of histology and digital pathology solutions

                • Digital pathology roundtable by industry leading-companies

                • Exclusive access to innovators and experts

                • Plus insights about disruptive consequences of new technology

Click Here for speakers, topics and times!

 

Lean for Lab Leaders: Achieving Mastery with Concepts, Implementation, and Outcomes

       Optional Post-Event Day on Thursday, April 29

                • Special for administrators, managers, and pathologists

                • All the knowledge and tools you need

                • Includes all the basics of Lean and work flow redesign

                • Hands-on mastery of core concepts and advanced applications

                • Highly-rated and the third year we’ve offered this training

                • Targeted learning includes case studies

Click Here for speakers, topics and times!

 

2010 Mid Winter Seminar -- February 26 – 27, 2010

The 2010 Mid Winter Seminar was be held on February 26 & 27, 2010 in Shreveport,
Louisiana. For a review of the materials covered, please contact the lab.

Recent CME

Array comparative genomic hybridization (also CMA, Chromosomal Microarray Analysis, Microarray-based comparative genomic hybridization, array CGH, a-CGH, aCGH, or Virtual Karyotype) is a technique to detect genomic copy number variations at a higher resolution level than chromosome-based comparative genomic hybridization (CGH).   Dr. Nordberg provided an overview of this technology at a recent Feist-Weiller Cancer Center research symposium.  aCGH, array-based karyotyping,  is viewed as an attractive companion to conventional cytogenetics in oncology. Many labs are beginning to use the array approach for samples (particularly breast cancer) where chromosomal analysis is needed but metaphases cannot be obtained by conventional cytogenetics. 

Tumors of unknown origin (TUO) (mystery tumors, carcinomas of unknown primary) are defined as histologicall proven tumors without identifiable primary site after a standard diagnostic workup.   At a recent Hematology/Oncology Grand Rounds, Dr. Nordberg covered this topic for the staff of the Feist-Weiller Cancer Center.  Items covered during this CME event included the pathogenesis, diagnosis , and treatment options for TUO and novel molecular diagnostic approaches for classification, and available molecular tests for defining TUOs.  

For a review of the materials covered, please contact the lab.

 

HIGHLIGHT TESTS:  KRAS

Treatments for patients with colorectal cancer (CRC) include several targeted monoclonal antibodies as well as conventional chemotherapeutic agents. Bevacizumab (Avastin®), cetuximab (Erbitux®), and panitumumab (Vectibix™) are some of the most common  anti-EGFR monoclonal antibodies used to treat metastatic CRC mCRC) patients. The mutational status of a oncogene called KRAS impacts how patients respond to anti-EGFR therapy.   Patients with KRAS mutations are less likely to respond to these therapies.  KRAS mutations can be detected in up to 45% of colorectal cancers.  In accordance with the National Comprehensive Cancer Network (NCCN) (http://www.nccn.org) , we are in the process of including KRAS mutation analyses for all patients with mCRC.  

BCR/ABL

Specialty: Hem/Onc Disease: CML Full abstract: (Click here)

Survival among chronic myelogenous leukemia (CML) patients can be linked to the reduction in leukemic cell burden. Treatment with imatinib mesylate (Gleeved, Novartis) results in a high frequency of complete cytogenetic response, which can be further stratified using quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR). We have serially monitored peripheral blood and bone marrow BCR-ABL transcripts using qRT-PCR in CML patients commencing imatinib therapy.

In keeping with our commitment to provide state-of-the-art rapid testing, we have recently validated Cepheid’s BCR-ABL* quantitative assay for patients with CML. Unlike existing method, which uses G6PDH as the internal standard, the new assay uses internal copies of ABL. In our validation studies, quantitative comparisons showed no significant differences between using G6PDH or ABL as the reference gene for this assay.

In keeping with NCCN guidelines and monitoring for BCR/ABL transcripts, the system delivers an automated, highly accurate nested real-time PCR assay for rapid, standardized test reporting in about 2 hours. Unlike other open systems, the GeneXpert® System is the only closed instrument platform to combine sample preparation with real time PCR amplification and detection functions for fully integrated and automated nucleic acid analysis. The system purifies, concentrates, detects, and identifies targeted nucleic acid sequences, delivering answers from unprocessed samples in about 2 hours.

Irinotecan Irinotecan (CAMPTOSAR (irinotecan HCl), Pfizer) is a chemotherapy agent used to treat metastatic colorectal cancer. CAMPTOSAR is used to treat colon cancer that has spread to other parts of the body. It is often taken with 2 other cancer drugs. They are called 5-FU (fluorouracil) and LV (leucovorin). Combinations including CAMPTOSAR have been shown to significantly extend survival for patients with colorectal cancer. Side effects from taking irinotecan may cause both "early" and "late" diarrhea. The early form happens within 24 hours of taking your chemo. It is often mild and goes away soon. The late form happens more than 24 hours after taking chemo. It can be very serious. Irinotecan treatment may lower the number of white blood cells in the body. This is called neutropenia. It means that you are more likely to get an infection. Diarrhea and neutropenia may cause severe adverse effects in some patients. 

Some patients carry alterations in the gene responsible for metabolizing irinotecan. Polymorphisms in this gene, UGT1A1, prevent the breakdown of the toxic byproduct of irinotecan, resulting in the associated toxicity of diarrhea and neutropenia. Most individuals have 2 copies of the same gene (UGT1A1* 28). Some individuals, however, carry polymorphisms which can now be identified with genetic testing. Patients with colorectal cancer can now be screened for polymorphisms in UGT1A1 before receiving irinotecan therapy to help identify patients at risk for adverse effects from the drug.  Testing for UGT1A1 polymorphisms is now available for patient identification. Contact the laboratory for more information.