Enterprise Interest. AstraZeneca

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1 Enterprise Interest AstraZeneca

2 Optimising access to personalised cancer therapy in The Netherlands; from tissue to therapy. Project PATH (Predictive Analysis for THerapy) Marjolijn Ligtenberg

3 Participating pathology departments Alkmaar, Symbiant BV Amsterdam, Amsterdam Medisch Centrum Amsterdam, Nederlands Kanker Instituut Amsterdam, Onze Lieve Vrouwe Gasthuis Amsterdam, VU medisch centrum Apeldoorn, Stichting Gelre ziekenhuizen Arnhem, Rijnstate Breda, Pathologisch en Cytologisch Laboratorium Amphia Delft, Reinier de Graaf Den Bosch, Jeroen Bosch Ziekenhuis Den Haag, Hagaziekenhuis Den Haag, Medisch Centrum Haaglanden/Bronovo Dordrecht, Laboratorium voor Pathologie Eindhoven, Stichting PAMM Gouda, Groene Hart Ziekenhuis Groningen, Martini Ziekenhuis Groningen, Universitair Medisch Centrum Groningen Haarlem, Spaarne Gasthuis Hengelo, Laboratorium Pathologie Oost Nederland Hoofddorp, Spaarne Gasthuis Leeuwarden, Pathologie Friesland Leiden, Leids Universitair Medisch Centrum Maastricht, Academisch Ziekenhuis Maastricht Nieuwegein, St. Antonius Ziekenhuis Nijmegen, Canisius-Wilhelmina Ziekenhuis Nijmegen, Radboud universitair medisch centrum Rotterdam, Erasmus MC Rotterdam, Maasstad ziekenhuis Rotterdam, Pathan Sittard-Geleen, Zuyderland Medisch Centrum Tilburg, St. Elisabeth Ziekenhuis Utrecht, Diakonessenhuis Utrecht, Universitair Medisch Centrum Utrecht Venlo, VieCuri Medisch Centrum Zwolle, Isala

4 Aim of the PATH project Collaboration between molecular pathology laboratories Technical innovations Harmonisation of targets Uniformity in interpretation Develop network of regional Molecular Tumour Boards Optimise translation of molecular data to clinical management Structured reporting of molecular data in nation-wide PALGA database use data for Cost Effectiveness Analyses enable sharing of data for other purposes

5 Aim of the PATH project Collaboration between molecular pathology laboratories Technical innovations Harmonisation of targets Uniformity in interpretation Develop network of regional Molecular Tumour Boards Optimise translation of molecular data to clinical management Structured reporting of molecular data in nation-wide PALGA database use data for Cost Effectiveness Analyses enable sharing of data for other purposes

6 PALGA The nationwide network and registry of histo- and cytopathology in the Netherlands Initiated 1971 Includes all Dutch pathology reports (complete since 1991) Use for patient care and research Policy to evolve from narrative to more structured synoptic reporting

7 PALGA Synoptic reporting module National standardised reporting system for molecular pathology Suited for all pathology labs and all molecular analyses Undemanding data input (e.g. automatic import of sequencing results) Number of required items Selection of items can be customised per lab in the control modus National consistence essential for effective reuse of data

8 Definition of analysed genes One centralised list of genes analysed in molecular pathology (updated on daily basis) Lab customisation: Define different gene panels For each panel and version, a PDF can be stored at PALGA for referral (link in report) Define different indications Combine indication and gene panel Define genes that should be reported explicitly Define whether to include gene panel and/or link to PALGA Define texts for molecular interpretation

9 Control modus Sequencing panels

10 Control modus Sequencing panels

11 The reporting module For most fields a default can be defined Select test Add percentage of tumor cells Add reference Import data from NGS platform (XML) Select predefined text for interpretation Imported sequencing results

12 Built molecular report

13 PATH IT architecture Digital Research Environment treatment IKNL PATH cbioportal PATH Database Knowledge Database uniform interpretation CRC, NSCLC, melanoma, GIST: TAT Yield etc PALGA CASTOR MTBs MTB Database therapy advice

14 Specific acknowledgements Lieneke Steeghs Paul Seegers Rick Spaan Stefan Willems Dutch clinical scientists in molecular pathology

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