Lymphoma Diagnosis

" Hi I'm Wayne Freedman thanks for joining us on this webcast live -- like any other disease in the doctors need an accurate diagnosis to give the best and most effective treatment for each patient. So while we spent a lot of time talking about new medications and new treatments we don't want to overlook. Diagnostic. Advances their exciting. And they're important and they didn't get overlooked here in San Francisco when the American society if he -- apology held its annual meeting."

" Among the hot topic something called DNA micro already analysis which researchers have. Developed to diagnose large B cell lymphoma. Micro already analysis that sounds complicated. So what is it."

" Well that's why we have guests thank goodness here is doctor Margaret ship fusion associate professor of medicine. At the Dana Farber cancer institute at Harvard University she directs the lymphoma program there. And we have Donohue the president of the lymphoma research foundation of America ladies thank you for joining us."

" Doctor what is it gene -- A contingent as a way of being able to understand me massive system itself. If you think about the way of the themselves knows how it should behave. There is basic genetic information. Encoded in DNA. DNA is then turned into our enemy and our name is made into approaching the proteins in the cell is actually what. Makes a -- do it's the instructions knicks so do when it should do. And what the gene chip allows you to do -- to examine those genetic instructions for all of the different genes. In that car for many of the different teams in the body. With a single approach and so the way that this works. Is that you may from a type of sound like you're interested in evaluating. RNA. And then you have a platform which is the chip. And that platform has on that. Representations. DNA. For thousands of genes and this is represented in a size that's probably smaller than a quarter. And what you can do -- you can take RNA. From a tumor cell. And overlay it on this chip that has thousands of genes represented. Wash it and -- with a special. Camera. And yet have computer representation. Of the expression of those thousands of machines just by looking at the information action -- you mean by expression. Expression is an indication of how much. Of a specific gene product exists in a certain cell. So you get an idea of how active that genius in itself is it high. I think it what are the levels high on the level slow and see you can begin to put together. The genetic information my understanding which genes are expressed at high levels. Which genes are expressed at low levels and understand what types of genes are active in different cell types and in. You always get different road map depending on to. Yes almost certainly we do. When you look innocent we look at a place when you see the active cells and then you can determine. You basically what you do is you examine with a single -- of the gene expression from all of the different genes that are represented on that -- so what you can do is get. Basically a blueprint. Of the gene activity. In us now by looking at the pattern on that -- so then what you need to do wish you need to compare. To understand how that similar. Or different. On two different from other tumors from. Normal cells from other types of cancer and so by getting the initial information. And then by comparing the information to similar sorts of information and other tumors. And in other normal cells you can begin to put together. On. Stories of how the tumors are different. And begin to from -- understand enough to think about developing treatments that are specifically tailored. To the patterns of expression. In specific tumor types how many cells and looking at around one. How many specific -- and he. How many how many genes are you looking one. Well the technology is improving very rapid. The type of chips that we've been -- and have about 7000 genes on a single chip. There are now chips that include up to almost 20000 -- on a single ship. The human. That the human genetic machinery. Is thought to probably be included in about 35000. -- although probably only have 35000 genes total. And so by looking at 7000 genes here covering a significant percentage of all of the genetic information. And very soon we'll be able with a single chip to. And evaluate literally the expression of all of the genes that contribute to that information you isn't isn't saved it to an -- gene. In this case and as this week. A -- I think would be part of a blueprint the information that tells you how to function. And -- information can include. Us on telling. The information can include switches that should I want switches that -- can lock. It's all of the information that sound needs to operate in the same way. That any machine. Needs certain information in order to. People -- On it tells the cells to grow the cells that tells us -- to stop growing it tells us now to die. To not die in different types of -- would have a different matter yes yes. Did he pattern would be different for two reasons. One would be that the cells that make up the one. Are different. And also that there are differences between normal cells in between -- This is still fairly early this is very early this is early days as an effective any treatment. On it has not affected treatment and I think that. The I think that we all are hopeful. That eventually. This sort of information will. Results in more specific. Treatments for patients. But it's likely that that process -- taking this sort of information and turning it into better more specific treatments for patients. Will take several years. But the whole -- that we can identifying. Specific. Characteristics. Of patient's tumor cells can buy it understanding those characteristics. Develop treatment approaches that are designed. To. Affect those processes. That have gone wrong in certain types of tumor he's talking about team making -- exactly. Specific drugs aimed at specific -- exactly. Post them all -- taken down exactly. So help you identify -- And you presented here specifically about -- About lymphoma is about a specific type -- from them. There are many different types of lymphoma actually over thirty different types of the most common type. And adults and sit -- diffuse large B cell lymphoma. Without a third of all when Thomas and -- outside these diffuse large B cell phones. And one of the things that has been most difficult. For patients and for doctors who take care of patients. Is that it's not possible justify making a diagnosis using the techniques that are available now. To have accurate information about how well patient we'll do with our standard types of treatment. A significant number of patients actually can be cured. With the types of treatment that we already have available about 40% of patients. -- about 60%. Are not effectively treated in going to die of their disease. And so would be very important for us to understand. What the basis for the differences are between those type of groups because what we'd like to do was be able to. More effectively treat and more specifically treat. The tumors from patients that are not effectively treated with our current. Chemotherapy utility which way to go earlier correct. Hopefully well it will give us eventually information. Regarding. Which way to go home early what's the timeline. Well the timeline that depends on how quickly we can take the information comes from this type of approach. Identify. Specific ways that -- specific clues. About ways that could be more effective in terms of treating tumors and then translate that information into treatment strategies. Usually it's a matter of years to go from an observation. About. Clues toward which clues about. Better treatments to actually. Translating that into better treatments for patients if a person were diagnosed and disaffection. Not tomorrow three years. It's very hard to send me -- as a matter of years before this type of technique will affect treatment. It's hard to know whether it's screening area -- five. Some of its -- some of that is. The rapid advancement in how we can actually take this information into the clinic. Years essentially you've got tool you don't know exactly. Where you're gonna work -- how you're going to be -- how far you'll be able to go. Well I think that they're value of this sort of approach is that it gives you. Information about. Ways to. Begin to develop. More specific treatment approaches but that process of development is still had a box and that process of development can be shorter. -- longer depending upon. The target that we're trying to hit and -- approach that's necessary in terms of actually hitting -- target. --"

" When I I -- these things for patients here is that at some point in the future. Positions will be able to use these technology that happens assassins. To separate out feminist -- diffuse large B cell lymphoma patients. Those patients who would do non standard therapy and those patients who would not do well."

" For those patients who would not too well. Investigators will be motivated to search for and I -- to find new targets that they can -- Then working on in order to develop new therapies that would be effective and beneficial for this subset of patients that would not do well. -- standard treatment. It sounds like -- a little work. We do don't retire into tougher with. Thank you for joining us and thank you for joining us on this webcast I'm winning streak."