Thomas Grogan of Roche Ventana Medical Systems Provides Pathologists Predictions about Anatomic Pathology
Posted on Friday, April 30, 2010
Being an employee of Definiens, I am very encouraged by Dr. Grogan’s predictions. Definiens for years has been on the forefront of quantitative, multiplexed analysis of localized biomarkers, as well as morphological quantification of individual cells. This was the purpose of the development of Definiens Tissue Studio, which facilitates translational research towards these ends. The Definiens XD platform facilitates the deployment of Definiens technology in the clinical setting: Clarient (breast cancer IHC algorithms) and Aureon (prostate cancer H&E and immunofluorescence algorithms for morphology and biomarker localization and expression, respectively) are two examples. Going forwards, Definiens Tissue Studio (for translational research) and Definiens XD platform (for CLIA or 510K diagnostics) together will facilitate points 1, 2, 4, and 5 below:
More multiplex and multi-analyte testing lies ahead for clinical pathology laboratories.
Several experts predict that clinical pathology laboratories will see the use of multiplex assays and multi-analyte diagnoses increase significantly in the near future. As this happens, both the science and the operations of clinical laboratories and pathology practices will grow in sophistication and complexity.
This week at the Executive War College on Laboratory and Pathology Management in New Orleans, Louisiana, almost 600 pathology and laboratory leaders gathered from 12 nations across the globe. During Wednesday’s general session, Thomas M. Grogan, M.D., Founder and Chief Scientific Advisor of Roche Ventana Medical Systems laid out his vision of how surgical pathology will evolve in the future.
Grogan organized his predictions around six key areas of science which are experiencing rapid refinement and will contribute to new capabilities within anatomic pathology. He characterized each as a forward move “beyond” the current status quo:
* First, beyond diagnosis to therapeutics. Grogan noted that new lab testing technologies give pathologists more precise understanding about the disease being studied. In turn, that additional knowledge makes it possible to pathologists to identify which therapies will be most appropriate for the patient.
* Second, beyond single-analyte diagnosis to widespread use of multiplexing. This is appropriate because both clinicians and patients want more sophisticated knowledge about the tissue, the disease, and the most appropriate therapies.
* Third, Beyond protein to “gene + protein” assays. Grogan provided several cases to illustrate how the standard of practice for selected types of cancers now requires more than just protein analysis. To provide a more sophisticated understanding of the patient’s disease, pathologists will evaluate the specimen using both protein and genetic assays.
* Fourth, Beyond qualitative to quantitative assays. This is a steady shift away from “yes or no” assays in favor of lab tests which provide more detailed information about the cancer being diagnosed. It is this richer set of data which the clinician can use to identify therapies likely to be effective, to monitor the patient, and to predict recurrence of the disease.
* Fifth, Beyond informatics to cellular informatics. This relates to the detailed understanding of cells, including individually and collectively, along with their functional and spatial relationships within the tissue. He emphasized the importance of morphological context.
* Sixth, Beyond written reports to electronic patient-centric reports. On this point, Grogan emphasized the need for pathologists to be more consultative and to contribute to the creation of an integrated report which incorporates all the relevant clinical data for the physician and the patient.