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Virchows Archiv : An International... Feb 2024The continuing evolution of treatment options in thoracic oncology requires the pathologist to regularly update diagnostic algorithms for management of tumor samples. It... (Review)
Review
The continuing evolution of treatment options in thoracic oncology requires the pathologist to regularly update diagnostic algorithms for management of tumor samples. It is essential to decide on the best way to use tissue biopsies, cytological samples, as well as liquid biopsies to identify the different mandatory predictive biomarkers of lung cancers in a short turnaround time. However, biological resources and laboratory member workforce are limited and may be not sufficient for the increased complexity of molecular pathological analyses and for complementary translational research development. In this context, the surgical pathologist is the only one who makes the decisions whether or not to send specimens to immunohistochemical and molecular pathology platforms. Moreover, the pathologist can rapidly contact the oncologist to obtain a new tissue biopsy and/or a liquid biopsy if he/she considers that the biological material is not sufficient in quantity or quality for assessment of predictive biomarkers. Inadequate control of algorithms and sampling workflow may lead to false negative, inconclusive, and incomplete findings, resulting in inappropriate choice of therapeutic strategy and potentially poor outcome for patients. International guidelines for lung cancer treatment are based on the results of the expression of different proteins and on genomic alterations. These guidelines have been established taking into consideration the best practices to be set up in clinical and molecular pathology laboratories. This review addresses the current predictive biomarkers and algorithms for use in thoracic oncology molecular pathology as well as the central role of the pathologist, notably in the molecular tumor board and her/his participation in the treatment decision-making. The perspectives in this setting will be discussed.
Topics: Female; Humans; Carcinoma, Non-Small-Cell Lung; Lung Neoplasms; Pathology, Molecular; Biomarkers, Tumor; Biopsy
PubMed: 37801103
DOI: 10.1007/s00428-023-03651-1 -
The Journal of Molecular Diagnostics :... Feb 2022
Topics: Biomarkers; Humans; Pathology, Molecular; Surveys and Questionnaires
PubMed: 34838775
DOI: 10.1016/j.jmoldx.2021.11.003 -
The Lancet. Oncology Oct 2021The 2013 SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) Statement provides evidence-based recommendations for the minimum content to be... (Review)
Review
The 2013 SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) Statement provides evidence-based recommendations for the minimum content to be included in a clinical trial protocol. Assessment of biospecimens is often required for trial eligibility or as part of an outcome evaluation, and precision molecular approaches are increasingly used in trial design. However, cellular and molecular pathology practices within trials have not been codified or formalised. We developed international consensus reporting guidelines for cellular and molecular pathology content in clinical trial protocols (the SPIRIT-Path extension) using an international Delphi process, which assesses candidate items generated from a previous systematic review, followed by an expert consensus meeting. 74 individuals from five continents responded, including clinicians, statisticians, laboratory scientists, patient advocates, funders, industry representatives, journal editors, and regulators. The SPIRIT-Path guidelines recommend 14 additional items (seven extensions to the SPIRIT checklist and seven elaborations) that should be addressed in trial protocols containing pathology content, alongside the SPIRIT 2013 Statement items. SPIRIT-Path recommends that protocols should document the individuals, processes, and standards for all cellular and molecular pathology components of the trial, including all stages of the specimen pathway and any digital pathology methods, with specific consideration of the value of trial data and biological tissues for additional translational studies.
Topics: Checklist; Clinical Trial Protocols as Topic; Clinical Trials as Topic; Consensus; Delphi Technique; Humans; Pathology, Molecular; Research Design
PubMed: 34592193
DOI: 10.1016/S1470-2045(21)00344-2 -
Pathologie (Heidelberg, Germany) Dec 2023The situation regarding digital pathology in Austria is manageable compared to other countries. Active Austrian examples are the consortium EMPAIA, the private-public... (Review)
Review
The situation regarding digital pathology in Austria is manageable compared to other countries. Active Austrian examples are the consortium EMPAIA, the private-public partnership Bigpicture, the Austrian Society for Clinical Pathology and Molecular Pathology (OEGPath), the company TissueGnostics, and the Austrian Platform for Personalized Medicine (OEPPM).
Topics: Austria; Telepathology; Pathology, Clinical; Pathology, Molecular; Precision Medicine
PubMed: 37987811
DOI: 10.1007/s00292-023-01278-2 -
Ticks and Tick-borne Diseases Mar 2022Molecular biology has revolutionized all aspects of biological research including diagnostics, taxonomy, and systematics. Even so, the critique that molecular methods... (Review)
Review
Molecular biology has revolutionized all aspects of biological research including diagnostics, taxonomy, and systematics. Even so, the critique that molecular methods cannot truly confirm the presence of parasites, or identify new species remains prevalent and arguably relevant. The current review considers the ability of molecular diagnostic methods to detect parasites and the relevance of molecular sequences to identify species and attempt to answer the question of whether molecular data ever lie. It shows that well-validated molecular assays should be able to accurately confirm the presence of parasites in a host or vector species, while well-selected sequences should conclusively identify existing or new species. It addresses pitfalls in the use of molecular techniques and how these can be avoided. It also considers the self-correcting nature of science and the caveat that a scientist should use all tools at their disposal to uncover the mysteries of nature.
Topics: Animals; Parasites; Pathology, Molecular
PubMed: 35078135
DOI: 10.1016/j.ttbdis.2022.101907 -
Science (New York, N.Y.) Jun 2020
Topics: COVID-19; Coronavirus Infections; Financing, Government; Humans; Pandemics; Patents as Topic; Pathology, Molecular; Pharmaceutical Preparations; Pneumonia, Viral; Vaccines
PubMed: 32499414
DOI: 10.1126/science.abc7472 -
American Journal of Clinical Pathology Jul 2020At a discussion on molecular/cytogenetic education for hematopathology fellows at the 2018 Society for Hematopathology Program Directors Meeting, consensus was that...
OBJECTIVES
At a discussion on molecular/cytogenetic education for hematopathology fellows at the 2018 Society for Hematopathology Program Directors Meeting, consensus was that fellows should understand basic principles and indications for and limitations of molecular/cytogenetic testing used in routine practice. Fellows should also be adept at integrating results of such testing for rendering a final diagnosis. To aid these consensus goals, representatives from the Society for Hematopathology and the Association for Molecular Pathology formed a working group to devise a molecular/cytogenetic curriculum for hematopathology fellow education.
CURRICULUM SUMMARY
The curriculum includes a primer on cytogenetics and molecular techniques. The bulk of the curriculum reviews the molecular pathology of individual malignant hematologic disorders, with applicable molecular/cytogenetic testing for each and following the 2017 World Health Organization classification of hematologic neoplasms. Benign hematologic disorders and bone marrow failure syndromes are also discussed briefly. Extensive tables are used to summarize genetics of individual disorders and appropriate methodologies.
CONCLUSIONS
This curriculum provides an overview of the current understanding of the molecular biology of hematologic disorders and appropriate ancillary testing for their evaluation. The curriculum may be used by program directors for training hematopathology fellows or by practicing hematopathologists.
Topics: Curriculum; Education, Medical, Graduate; Fellowships and Scholarships; Hematology; Humans; Pathology, Clinical; Pathology, Molecular
PubMed: 32444878
DOI: 10.1093/ajcp/aqaa038 -
Advanced Materials (Deerfield Beach,... May 2023The global outbreaks of infectious diseases have significantly driven an imperative demand for rapid and accurate molecular diagnostics. Nucleic acid amplification tests... (Review)
Review
The global outbreaks of infectious diseases have significantly driven an imperative demand for rapid and accurate molecular diagnostics. Nucleic acid amplification tests (NAATs) feature high sensitivity and high specificity; however, the labor-intensive sample preparation and nucleic acid amplification steps remain challenging in order to carry out rapid and precision molecular diagnostics at home. This review discusses the advances and challenges of automatic solutions of sample preparation integrated with on-chip nucleic acid amplification for effective and accurate molecular diagnostics at home. The sample preparation methods of whole blood, urine, saliva/nasal swab, and stool on chip are examined. Then, the repurposable integrated sample preparation on a chip using various biological samples is investigated. Finally, the on-chip NAATs that can be integrated with automated sample preparation are evaluated. The user-friendly approaches with combined sample preparation and NAATs can be the game changers for next-generation rapid and precision home diagnostics.
Topics: Pathology, Molecular; Body Fluids; Saliva; Nucleic Acids; Nucleic Acid Amplification Techniques
PubMed: 36416278
DOI: 10.1002/adma.202206525 -
Surgical Pathology Clinics Sep 2021
Topics: Humans; Molecular Diagnostic Techniques; Pathology, Molecular
PubMed: 34373102
DOI: 10.1016/j.path.2021.05.014 -
Der Chirurg; Zeitschrift Fur Alle... Nov 2021New diagnostic tools in the field of oncology that became available with introduction of the next generation sequencing call for adjustments in the current clinical... (Review)
Review
BACKGROUND
New diagnostic tools in the field of oncology that became available with introduction of the next generation sequencing call for adjustments in the current clinical workflow. To ensure correct interpretation, newly collected data need to be processed and categorized properly. Thus, current experts in oncology need to be trained and new experts from other fields need to be recruited.
OBJECTIVES
The molecular tumor board was introduced to bring experts from various specialties together. The goal is to discuss and assess complex oncological cases in the context of new molecular diagnostics and give recommendations regarding individualized therapy.
RESULTS
After the introduction of the molecular tumor board 2 years ago, the number of cases processed within the molecular tumor board has increased steadily. Of these patients, 70% exhibit molecular alterations that are relevant to therapy. Preliminary results indicate positive responses to the applied therapies and clear improvements in the progression-free and overall survival of patients who would have been considered "untreatable" in the classical clinical setting.
CONCLUSION
The introduction of new molecular diagnostics makes the establishment of advanced clinical structures mandatory. In this regard, the molecular tumor board continues to gain in importance. Preliminary results point towards a significant impact on the therapy of advanced malignancies. The advancements in sequencing and newly established insights into the interpretation of sequencing results will lead to new therapeutic routes. Inevitably, this will make the molecular tumor board indispensable in the future.
Topics: High-Throughput Nucleotide Sequencing; Humans; Medical Oncology; Neoplasms; Pathology, Molecular; Precision Medicine
PubMed: 34406439
DOI: 10.1007/s00104-021-01487-6