We can start moving on in, can you show that. Can you put up that slide that was just up? As you get coming in, just to highlight that there continues to be interest in this area this is a slide that Dr. Scher meant to show in his presentation, but there is an upcoming conference focusing on a very similar topic a Gordon Conference in Mt. Holyoke at Massachusetts. I hope there is AC at the dorms where people are staying. Okay, so in this session we will focus on liquid biopsies in lung cancer drug development and clinical use. We will have two presentations and then a panel discussion and I’ll invite the panelists to come up afterwards. Now lung cancer works out as a really an ideal disease in which liquid biopsies may be used. Lung cancer is of course a disease where genotype directed therapy is the standard of care and we have multiple targeted therapies approved for specific genomic subsets of the disease such as; EGFR inhibitors, ALK inhibitors and RAS inhibitors. Lung cancer patients of course ones where biopsies, traditional tumor biopsies can be challenging, either the tumor is in a location that’s difficult to biopsy such as next to the aorta or next to some other structure or the patient’s comorbidities prevent you from doing a biopsy. Somebody who was bad COPD for example where the risks of biopsies are as significant, and hence having alternative technologies that are able to not only diagnose the specific genotypic subset of the disease but ultimately be used in monitoring etcetera. Of course we have agents that are approved when patients develop resistance to targeted therapies and understanding the specific mechanism or resistance, again which can be determined from a non invasive method may help guide the particular therapy that the patient should receive at that point. As Gideon mentioned earlier we now have just a reason approval and we will hear more about this later on today of the first cfDNA assay for EGFR mutation, EGFR activating mutation detection recently approved and available for clinical use. There is a lot of interest in this particular disease four liquid biopsies, again our first two presenters will talk about sort of the clinical use and where things are headed. Then I will go on to the panel discussion where we have representation from not only the first two speakers but also members from different companies that are making targeted therapies in the lung cancer space, and also have interest in and liquid biopsies in that as well. Without further ado I will introduce our first speaker Geoff Oxnard from the Dana-Farber Cancer Institute who will speak on plasma genotyping for treatment selection of advanced non-small cell lung cancer, Geoff.
Thanks Pasi and thank you for inviting me to speak today. I want to talk about plasma genotyping in treatment selection for advanced lung cancer. I’m a clinical investigator, I don’t work in the lab I work with labs. I’m going to try to bring this really focused on patients and how we can use this to help patients using three patient cases; a patient with newly diagnosed lung cancer, a patient with a quite resistant EGFR-TKI and a patient with suspect reoccurrence of lung cancer. All of these are patients of mine who over the past months I’ve used liquid biopsies try to help guide their care. In the first is a of forty nine year old never smoked who presents with cough and headache, CAT scan seen here shows a long mass and multiple lung nodules. I know to you forty nine and never smoke it doesn’t seem like lung cancer, but this is the kind of
patient population we are enriched for at academic centers. This is a unique patient who sure looks like they have lung cancer but doesn’t seem like your average type of lung cancer. This is a patient where cancer genetics has a potential to make a big difference in finding a targeted therapy for them. Brain MRIs done shows an eight millimeter a mass in the cerebellum, we can’t rule out leptomeningeal disease based on the scan which