BostonGene Tumor Portrait Report: How to Access & Understand Results
Featuring: Michael Hensley, Senior Strategic Account Manager at BostonGene; Michelle Lanman, National Sales Director at BostonGene
In short
BostonGene's Tumor Portrait Report combines DNA and RNA sequencing with immune profiling to give patients and doctors a detailed picture of a tumor's unique features, likely treatment targets, and chances of responding to immunotherapy. Michael Hensley and Michelle Lanman from BostonGene walk through how the report is built, what it shows about the tumor microenvironment, and how results connect to treatment guidelines and clinical trials.
- •Ask your doctor about RNA sequencing in addition to standard DNA sequencing — RNA can catch fusions and biomarkers that DNA alone may miss.
- •If immunotherapy is on the table, ask whether your tumor microenvironment has been profiled: immune-enriched tumors with high tumor mutational burden have a much stronger chance of durable response than suppressive, low-TMB tumors.
- •Your physician can order a BostonGene Tumor Portrait by submitting a requisition form along with a tissue sample from pathology and a blood or saliva draw; results typically come back in 10–12 calendar days.
- •If you get liquid biopsy results from different companies that don't match, that can reflect real differences in gene panels, sensitivity, and sequencing depth — bring both reports to your doctor to discuss.
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Brad Power and Russ Hollyer October 11, 2023 “The novel thing about BostonGene is being able to portray the tumor microenvironment. ” – Michael Hensley “What we do is show what the tumor microenvironment is composed of, and whether it's immune hot or immune cold.” – Michael Hensley
Meeting Summary
Advanced cancer patients want as much high quality data about their disease as they can get to inform their treatment decisions. Beyond the increasingly common DNA sequencing, there are emerging tests which can look at the transcription of your DNA to proteins (RNA sequencing and proteomics) and your tumor microenvironment.
These tests can uncover the unique features of your tumor, identify new personalized, targeted treatment options, and tell you whether you will be a likely responder to a therapy. Michael Hensley is uniquely qualified to describe some of the newer tests that you can consider.
He is a Senior Strategic Account Manager at BostonGene, and has sixteen years of diversified and comprehensive pharmaceutical, cancer diagnostics, and medical sales experience, and thirteen years of hospital experience in pharmaceutical and diagnostic sales. Michelle Lanman is National Sales Director at BostonGene. BostonGene provides comprehensive molecular and immune profiling to assist in treatment selection. In a recent discussion Dr.
Sumit Subudhi of MD Anderson described how he used BostonGene as a leading provider of immune system profiling. What are some of the tests and reports you should consider getting?
•Tumor analysis includes genomic profiling of tumors, including whole exome DNA sequencing and whole transcriptome RNA sequencing. DNA sequencing has become common, while RNA sequencing is less common. RNA sequencing can identify biomarkers and fusions that can lead to targeted treatment options. Using both DNA and RNA sequencing can paint a more complete picture of your cancer. BostonGene's Tumor Portrait Report provides actionable insights into a patient's cancer, including potential drug targets, prognosis, and clinical trial matching.
•Spatial analysis can identify immune-rich (“hot”) and suppressive (“cold”) tumor microenvironments, indicating whether you will be likely to respond to immunotherapy. Spatial analysis can create a three-dimensional picture of the tumor microenvironment and identify subclones, which can lead to new biomarker targets and improved cancer treatment.
•Liquid biopsies (blood draws) can provide valuable DNA information and immune system profiling. Blood is easier to access, and usually more current than tissue samples, but harder to analyze, and there may be differences between reports from different companies due to differences in sensitivity and sequencing depth. BostonGene's liquid biopsy test is going to be available soon.
•A tumor evolution report repeats DNA and RNA tests at different times to let you see how your cancer is evolving.
•Immune system profiling can tell you whether you will likely respond to immunotherapies. If your tumor microenvironment is immune-enriched, and tumor mutational burden high, you have an exceptional opportunity to have a durable benefit of immunotherapy in excess of 70 to 80% in some cancers. If you have a suppressive tumor microenvironment with a low tumor mutational burden, you have less than a 7% chance of a durable response to immunotherapy. BostonGene's multiplex immunofluorescence platform enables three-dimensional pictures (“spatial imaging”) of the tumor microenvironment, providing a more detailed understanding of how the tumor is interacting with its environment. How are your test results translated into treatment options and strategies?
•Your primary diagnosis, medical history, and genetic profile from the test results, especially biomarkers, are fed into a matching algorithm linked to the approved evidence-based treatments (the National Comprehensive Cancer Network guidelines) to provide personalized treatment recommendations.
•Algorithms matching biomarkers and treatments and clinical trials are constantly updated with new information from patients and the literature. How can you access these tests?
•You need to request tissue samples from pathology for DNA and RNA sequencing and get a blood draw for liquid biopsy tests.
•Your physician will order the tests through a requisition form.
•You give a saliva or blood sample for the normal DNA collection.
•Once these inputs are in the lab, they will usually have results in 10 to 12 calendar days. The information and opinions expressed on this website or platform, or during discussions and presentations (both verbal and written) are not intended as health care recommendations or medical advice by Cancer Patient Lab, its principals, presenters, participants, or representatives for any medical treatment, product, or course of action. You should always consult a doctor about your specific situation before pursuing any health care program, treatment, product or other course of action that might affect your health. Meeting Notes SUMMARY KEYWORDS tumor microenvironment, report, gene, tumor, boston, md anderson, biomarker, immunotherapy, sequencing, tests, information, clinical trial, therapy, liquid biopsy, tissue SPEAKERS or Portrait Report and How to Access It" Meeting Notes SUMMARY KEYWORDS tumor microenvironment, report, gene, tumor, boston, md anderson, biomarker, immunotherapy, sequencing, tests, information, clinical trial, therapy, liquid biopsy, tissue SPEAKERS Michael Hensley (62%), Michelle Lanman (15%), Rick Stanton (9%), Robert Gurmankin (9%), Amit Gattani (3%), Richard Anders (3%) OUTLINE 1.Personalized cancer treatment with BostonGene. (0:02) 2.Genomic sequencing and cancer diagnosis. (2:30) 3.Cancer diagnosis and treatment options using DNA and RNA sequencing. (6:55) 4.Cancer genetic testing and clinical trial matching. (14:25) 5.Immunotherapy and tumor microenvironment analysis. (18:00) 6.Cancer biomarkers and imaging technology. (24:45) 7.Using RNA sequencing for cancer treatment insights. (31:41) 8.Liquid biopsy and tissue biopsy differences. (35:25) 9.Liquid biopsy accuracy and variability. (41:05) 10.Cancer diagnostics and patient access to information. (48:52) 11.Cancer biomarkers and treatment strategies. (53:44) SUMMARY
•Michael Hensley from BostonGene discusses personalized cancer diagnostic testing.
•In a future session, BostonGene's Katerina Postovalova will describe BostonGene’s genomic profiling capabilities, highlighting rapid industry advancements.
•BostonGene provides comprehensive genomic profiling for various cancers, including prostate cancer, through their RNA sequencing and deconvolution tool, Cassandra.
•Their reports include a biomarker database based on the patient's primary diagnosis, and they collaborate with the NCCN guidelines to provide personalized treatment recommendations based on the patient's clinical history and genetic profile.
•The benefits of using both types of sequencing and the importance of comparing normal DNA to tumor DNA.
•The potential of RNA sequencing for identifying fusions and other biomarkers, and the importance of quantitative analysis versus observer variability in pathology labs.
•Researchers identify immune-rich and suppressive tumor microenvironments in cancer, with high TMB associated with improved response to immunotherapy.
•Example of a prostate cancer report at MD Anderson, highlighting key information such as patient details, tissue tested, tumor content, and treatment options.
•The importance of understanding the tumor microenvironment and immune enrichment for prostate cancer treatment.
•How BostonGene’s collaboration with NCCN can provide personalized recommendations for patients.
•The process of creating a BostonGene Tumor Portrait involves requesting tissue samples from pathology and marrying them with DNA collection for analysis.
•MD Anderson prioritizes clinical trial matches based on patient history and institution.
•BostonGene has a financial assistance program for eligible patients.
•Understanding the tumor microenvironment and how it responds to therapy.
•Doctors usually address information learned about the tumor microenvironment through medication and radiation. This information can be used to change treatment approaches for prostate cancer patients.
•Researchers aim to validate the potential of changing tumor microenvironments to improve immunotherapy responses.
•Rick Stanton discusses commercial availability of CODEX technology, which is expensive and not reimbursed for all patients.
•Michelle Lanman explains CODEX is a spatial imaging platform used by BostonGene, allowing for precise location of gene expression levels in tumors.
•The potential of using gene expression analysis to better understand cancer.
•While the technology is expensive, it could be offered as a fee-for-service.
•MD Anderson has customized two platforms for bladder cancer and prostate cancer.
•BostonGene is able to portray the tumor microenvironment and identify subclones, which can lead to new biomarker targets and improved cancer treatment.
•BostonGene is working to escalate clinical trial matches at MD Anderson by providing valuable insights and advocating for their trials.
•Rick Stanton discusses using immunohistochemistry to identify specific proteins in tumors.
•Rick Stanton shares how he uses RNA sequencing data to inform his cancer treatment decisions.
•Michelle Lanman provides valuable insights on spatial imaging and immuno- profiling, highlighting the importance of understanding the tumor microenvironment.
•Amit Gattani asks about calibration issues between liquid biopsy reports from different companies
•Michelle Lanman cites differences in sensitivity and sequencing depth.
•Blood is harder to analyze than tissue for cancer cells.
•Marketing efforts may vary between companies.
•Differences in liquid biopsy tests, including gene panels and technology used, can result in variations in reported findings.
•Challenges with liquid biopsies, including true negatives and false positives. Tumor Portrait Report and How to Access It"
•Challenges with liquid biopsies, including true negatives and false positives. BostonGene addresses these issues through chip filtration.
•Robert Gurmankin asks about the outcomes of liquid biopsy reports and their impact on treatment decisions.
•Richard Anders asks about following patients for clinical outcomes in dozens of cancer types, with some cases being formal partnerships and others being informal case reports.
•Following metastatic castrate resistant prostate cancer patients with high TMB and high MSI, treating them with immunotherapy and monitoring outcomes.
•Integrates emerging biomarkers and clinical outcomes into reports for patients and physicians.
•Richard Anders: Asks about the number of tests done per month, interested in stratifying the universe for statistical significance.
•BostonGene gets in about 400 tests a month, mostly from MD Anderson.
•BostonGene's internal databases, including biomarker and clinical trial databases, are constantly updated with new information from patients and literature.
•Tumor microenvironment in primary tumors can be positive, but changes to fibrotic in bone or other tissues over time.
•Challenges and opportunities in understanding and treating cancer, with a focus on tumor microenvironment and evolution. Meeting
Full transcript
Robert Gurmankin Welcome to this Cancer Patient Lab meeting with Michael Hensley from BostonGene. As advanced cancer patients, we always want to have the best data about our disease as possible to help inform treatment decisions. BostonGene provides AI-based molecular and immune profiling. Their tests uncover unique features of our tumor, enabling doctors to design the best treatment for our cancers. In a recent discussion we had with Dr.
Subhudi from MD Anderson, Dr. Subhudi described how he used BostonGene as a leading provider of immune profiling. He's the one who got us in touch with BostonGene. Today, our speaker is Michael Hensley, senior strategic account manager at BostonGene, with 16 years of diversified comprehensive pharmaceutical cancer diagnostic medical experience. He'll be presenting a BostonGene report and explain how patients can get access to their services.
I want to thank Michael and also Dr. Subhudi for helping me and Brian McCloskey get some testing. We have to find out what's happened with my samples. We also have a meeting coming up with Katerina Postovalova of BostonGene for an inside look at how it's being done. Michael Hensley 2:29 Yes. Katerina’s going to be presenting all the BostonGene capabilities outside of our commercial Tumor Portrait Test.
Michael Hensley
Thank you all so much for having me today. This has been a very exciting adventure, starting to work with Cancer Patient Lab. I'll lead with this: I'll never forget when BostonGene was recruiting me.
I had just celebrated my one-year anniversary, and one of my great mentors, the chair of breast oncology at MD Anderson, was telling me about how this industry, next gen sequencing or comprehensive genomic profiling, whatever you want to call it, is advancing so rapidly. It's like computers were in the 1990s. By the time you brought a new computer home, it was already out-of-date. There was already faster RAM, better video cards, and so forth.
That's how this industry is progressing. I came to BostonGene because I truly believe that we are leading that revolution. When you think about it, everybody does sequencing to a certain aspect. The question is: what can you do with the sequencing besides just providing biomarker targets with therapies or biomarker targets that have a matched prognosis? At BostonGene, we do all that and more. We now have four different tests.
Today, I'm going to focus on our tissue Tumor Portrait Report test because it is our most comprehensive. We do whole exome sequencing, where we look at all of the 21,000 genes in the DNA. We do the whole transcriptome, so we're looking at all of the RNA. There are no limited panels here.
If you look at all of our research collaborations, if we want to go back and mine all the sarcoma patients at MD Anderson for an emerging biomarker, we can do that because it was in our sequencing. The biggest thing at BostonGene that is the most exciting for prostate cancer is we use our RNA sequencing through a deconvolution tool that we've named Cassandra to portray the tumor microenvironment.
Everybody investigates that tumor biopsy or that metastatic lesion as the seed, but we go and investigate all of the normal tissues surrounding that. We also do companion IHCs. In our reports, we've mined it through a biomarker database that's based on that primary diagnosis. All the reports will be different based on the patient's primary diagnosis. We also have a formal collaboration with the NCCN guidelines.
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