Faculty Disclosure
In accordance with ACCME guidelines, any individual in a position to
influence and/or control the content of this ASCP CME activity has
disclosed all relevant financial relationships within the past 12 months
with commercial interests that provide products and/or services
related to the content of this CME activity.
The individual below has responded that he/she has no relevant
financial relationship(s) with commercial interest(s) to disclose:
William K. Funkhouser, MD PhD
Molecular Pathology: The Future
Wm. K. Funkhouser, MD PhD
UNC Pathology & Lab Medicine
Our Future Pathology Practice will be:
Citius - Faster
Altius - Higher
Fortius - Stronger
Citius - Faster
Faster Transfer from Discovery to Practice
Galen to Harvey: Millennium
Scurvy to citrus on ships: Century
PCN to production: Decades
HER2 amp, EGFR muts to Rx: Years
ASCO meets annually….
Faster Technology
Automation of chemistry
Miniaturization of chemistry
Computer analysis of data
Faster Risk Estimates
For clinically unaffected individuals:
Etiologic mutation screening for couples
Etiologic mutation screening of relatives
Faster Diagnosis
Molecular subtypes
Specific translocations
Germline etiologic mutations
Faster Prognosis
Hemochromatosis
A1AT deficiency
Cystic fibrosis
Medullary thyroid Ca in MEN2
MMR-defective colorectal Ca
Faster Prediction of Therapeutic Response
Individual differences in drug metabolism
“Druggable” mutant protein kinases
ID of resistance mutations
Faster Detection of Copy Number Variation
Gene Amplification
Allelic Loss
Multiplex testing
ISH
Faster Translocation Detection
Metaphase spreads
Locus-specific probes
Faster Sequence Variation Detection
Prenatal/Newborn screening
HLA loci
Germline vs. neoplasm muts
Fusion partners
Clonal Ig or TCR
Faster Epigenetic Testing
Histone protein modification
DNA promoter methylation
Imprinting abnormalities
Faster RNA Abundance Cluster Analysis
mRNAs
µRNAs
Their equilibria
Altius - Higher
Higher Complexity
Multi-analyte tests
Traits
Statistics
Higher Confidence
Risk prediction
Diagnostic, prognostic, predictive
Management guidance
Higher Productivity
Timely reporting of accurate diagnoses with
useful predictive data
Prompt guidance of the treating clinician,
particularly re. expensive targeted therapies
Fortius - Stronger
Stronger Associations
Statistical associations
Organizational associations
Stronger Opinions
Education of lawyers, legislators,
judges, and payors
Stronger Conclusions
Better diagnostic reproducibility
Better diagnostic accuracy
Better outcome prediction
Better management guidance
.
Going forward, Molecular Pathology will
Improve our understanding of disease risk,
etiology, pathogenesis, and outcomes
Complement morphology
Benefit our patients, our treating clinicians,
and ourselves
Thanks to:
Drs. Myers, Humphrey, DeYoung (ADASP Leaders)
Drs. Eberhard, Sepulveda, and Pfeifer (Speakers)
Drs. Gulley, Weck, Tsongalis, and Nowak (AMP)
You, for participating in this ADASP meeting