September 2018

  • Molecular ‘bucket list’ for renal cancer

    September 2018—Leo Tolstoy is not listed as a coauthor on the most recent iteration of The Cancer Genome Atlas on renal cell carcinoma, which focuses on molecular characterization of RCC. But the topic is as rich and complex as a Russian novel, and the authors’ approach is so comprehensive, it’s tempting to picture them at least holding forth at a certain soirée in Saint Petersburg (minus the after-party drunkenness and the bit with a bear, of course). The project may not be as sprawling as War and Peace, which marches 559 characters, speaking two languages, over four volumes, 15 parts, and 333 chapters. It’s a heroic effort nonetheless. There is much to keep track of in renal cell carcinoma, both generally and in this latest document, which evaluates 843 RCCs from three major histologic subtypes, including 488 clear cell RCC, 274 papillary RCC, and 81 chromophobe RCC.

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  • Hemophilia drug interferes with APTT-based assays

    September 2018—When a miracle drug comes along that is predicted to cause havoc in the laboratory, the drug could well seem like a double-edged sword. In the case of emicizumab (Genentech’s Hemlibra), for patients with hemophilia A, the mix of both benefits and drawbacks is likely to settle in for the long term.

  • Forward march on commercial NAAT for M. genitalium

    September 2018—About five years ago, when William M. Geisler, MD, MPH, was still focusing his research at the University of Alabama at Birmingham on chlamydia, Mycoplasma genitalium carried a lower profile as a cause of sexually transmitted infection.

  • For autopsy service, new requirements in AP checklist plus nine new requirements for forensic autopsies

    September 2018—Quality management, communication, and consent are among the issues addressed in new and revised requirements in the autopsy pathology section of the latest edition of the CAP accreditation program anatomic pathology checklist.

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  • Put It on the Board

    Broad-based molecular testing for NSCLC September 2018—A recently published study on broad-based genomic sequencing and survival among patients with advanced non-small cell lung cancer in the community oncology setting should not lead to the conclusion that such sequencing should be avoided in nonsquamous NSCLC, say Paul A. Bunn Jr., MD, and Dara L. Aisner, MD, PhD, of the University of Colorado Denver, Aurora. Dr. Bunn, of the Department of Medical Oncology, and Dr. Aisner, of the Department of Pathology, in an editorial published Aug. 7 in JAMA, caution readers about the study published in the same issue, which found that broad-based sequencing (more than 30 cancer genes) directly informed treatment in a minority of patients and was not independently associated with better survival. The study of 5,688 patients with advanced NSCLC was based on data acquired through abstraction and aggregation of information from the electronic medical record from 191 U.S. community oncology practices.

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  • Selected Pathology Abstracts
    Clinical pathology: Outcomes of an audit of repeat lab testing at an academic medical center. Read more.
    Anatomic pathology: Thymoma: a clinicopathological correlation of surgical resection cases. Read more.
    Molecular pathology: Ability of genetic alterations to predict development of acute myeloid leukemia. Read more.

  • Q&A column

    Q. Is there expert advice or standard practice for releasing preliminary critical values for patients to the LIS pending subsequent technologist or technician verification and documentation? Read answer.
    Q. We hope to validate a procedure for the fixation, decalcification, and staining of bone marrow specimens but we will not be able to access fresh marrow specimens for our decalcification validation. Can you recommend an alternative tissue to validate the preservation of tissue morphology and antigenicity after decalcification? Read answer.

  • Click to view these CAP TODAY departments:
    President’s Desk
    Q&A column

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CAP TODAY Recommends

  • Precision medicine conference for health network/hospital CEOs to take place Sept. 12–13

    Precision medicine strategies and successes in improving patient outcomes are key themes when hospital and health network CEOs and administrators gather in Nashville Sept. 12–13 to hear from innovators at Vanderbilt University Medical Center, Geisinger Health, Northwell Health, Moffitt Cancer Center, and Seattle Children’s Hospital, among others. “Precision Medicine for Hospital CEOs: What You Need to Know about Genetic Testing, Precision Medicine, and Population Health Management” ( will feature first-mover and early-adopter health networks sharing the strategies of their precision medicine programs and the patient care successes and outcomes. Keynote speaker is Jeffery Balser, MD, PhD, CEO of Vanderbilt University Medical Center, which is internationally recognized for its pioneering efforts to bring precision medicine into daily clinical care. Attendees will gain insight into the early successes of precision medicine at Vanderbilt and learn how the health care big data base at Vanderbilt is being used to inform population health initiatives while also guiding the care clinicians provide daily.

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  • Cancer Biomarkers Conference III

    Houston Methodist Department of Pathology and Genomic Medicine is presenting its Cancer Biomarkers Conference III, Sept. 15–16, at the Houston Methodist Research Institute. More than 20 speakers will cover topics such as updates on PD-L1 testing for lung cancer, urologic cancers, and melanoma, the current approach to using cytology specimens for biomarker testing, the oncologist’s approach to TKI therapy, and many more.

  • CMS national coverage decision on next-generation sequencing

    A new white paper titled “The CMS National Coverage Decision on NGS” from Diaceutics provides coverage of ongoing developments since the NGS national coverage decision was made. Read the white paper (requires free registration).

  • VIDEO SERIES: The future of the lab in health care

    In a collaborative effort to discuss the future of the laboratory in health care, Bob McGonnagle, publisher of CAP TODAY, gathered with Orchard Software’s Curt Johnson, chief operating officer, and Matt Modleski, chief operating officer, American Health Network. This roundtable was edited into a series of seven short videos.

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  • Cytopathology in Focus: Synergy in cytopathology and molecular microbiology

    August 2018—In today’s less-is-more world, health care consumers and providers often seek explicit and detailed information from minimally invasive procedures and tiny samples. Over are the days of “malignant cells present” and on to the next case. Cytopathologists and cytotechnologists are embracing and integrating novel techniques and applying new methods to the diagnosis and classification of essentially every imaginable form of neoplasia. The 2018 WHO publications confirm that 29 percent of deaths worldwide (more than 10 million people annually) are attributable to communicable diseases.1,2 This means the purpose of procuring many specimens is not to just rule out malignancy but also to diagnose infectious etiologies.

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  • Cytopathology in Focus: Why not call everything ASCUS?

    August 2018—Below is a question shared on the ASC listserv. My reply to the question follows. A pathologist colleague who practiced previously as an obstetrician/gynecologist is of the opinion that categorizing the level of abnormality we observe on a Pap test is a waste of time. All the clinician needs to know, he says, is whether the test is normal or abnormal. The Pap test is a screening test, he says correctly, and its only relevance is in pointing out who needs a colposcopy and biopsy.

  • Cytopathology in Focus: Cytology social media—Facebook and Twitter as networking tools

    August 2018—If you are not already using social media professionally, you may not know there is a vibrant and active community of pathologists, including many cytopathologists, on Facebook and Twitter—and getting involved is easy, fun, and educational.

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  • FDA clears lysosomal storage disorder test

    September 2018—PerkinElmer has received FDA 510(k) clearance for its NeoLSD MSMS kit, an in vitro ...

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  • MU School of Medicine, Roche team up

    September 2018—Roche announced the result of a collaboration with the University of Missouri School of Medicine to implement the company’s Navify tumor board solution, cloud-based clinical workflow and decision-support software to assist with cancer patient case reviews in tumor board and multidisciplinary team meetings.

  • Tibsovo approved for patients with R/R AML with IDH1 mutation

    September 2018—Agios Pharmaceuticals announced that Tibsovo (ivosidenib) was granted FDA approval for the treatment of adult patients with relapsed or refractory acute myeloid leukemia with a susceptible isocitrate dehydrogenase-1 mutation, as detected by an FDA-approved test. Tibsovo is an oral, targeted inhibitor of the IDH1 enzyme. The efficacy of the drug was studied in a single-arm trial of 174 adult patients with relapsed or refractory AML with an IDH1 mutation. The trial measured the percentage of patients with no evidence of disease and full recovery of blood counts after treatment, as well as patients with no evidence of disease and partial recovery of blood counts after treatment. With a median follow-up of 8.3 months, 32.8 percent of patients experienced complete remission or complete remission with partial hematologic recovery that lasted a median 8.2 months. Of the 110 patients who required transfusions of blood or platelets due to AML at the start of the study, 37 percent went at least 56 days without requiring a transfusion after treatment with Tibsovo.

  • Leica rolls out next-gen research stainer

    September 2018—Leica Biosystems introduced the Bond Rx next-generation research stainer. The system offers greater flexibility when optimizing conditions for a variety of test types including immunofluorescence, immunohistochemistry, fluorescence in situ hybridization, tyramide signal amplification, multiplexing, and other emerging tests.

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