“Comparing Test Results and Treatment Strategies across 10 Advanced Prostate Cancer Patients”

over a year and a quarter from each therapy. Two patients are outliers. On the high end is Ken Anderson, who has gotten just over two years per systemic treatment. Ken has been

“Comparing Test Results and Treatment Strategies across 10 Advanced Prostate Cancer Patients” (Brian McCloskey) [#45] living with aggressive cancer and bone mets, and he had over 25 rounds of chemotherapy (docetaxel). On the low end, unfortunately, is Mike Yancey, who is getting less than six months per systemic therapy. Any therapy that he takes has no durability.

Once he completes his treatment, he gets two to three months after that, at best, and then the cancer is on the run again, and he needs to find another treatment. What are the major findings about the Prostate Cancer Lab community? We have a really engaged patient group. They are educating themselves and leaning in to try new tests and treatments. Patients are learning from each other.

What have we learned you should do if you are an advanced cancer patient? 1.Use your existing genomic and other data to get a full portfolio of treatment options. There's an opportunity to leverage our treatment matching service partners to get more treatment options. 2.Get deeper diagnostics if you can.

If you can get the raw data from your diagnostics vendor, then you can take it to another vendor for additional insights. For example, Mike Yancey took his raw RNA data from Tempus to SHEPHERD Therapeutics for them to run their RNA seq analysis. 3.Talk to your physician about how to maximize the useful life of your systemic therapies. 4.

Refresh your diagnostic data as you see more lines of therapy. Monitor your disease progression, such as getting weekly PSA tests. 5.Gather your story into a one-page summary, including your PSA over time, overlaid with treatments, and the treatment options you are considering next, so that you can get advice on priorities and strategy.

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/Prostate Cancer 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.

“Comparing Test Results and Treatment Strategies across 10 Advanced Prostate Cancer Patients” (Brian McCloskey) [#45] Meeting Notes 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/Prostate Cancer Lab, its principals, presenters, participants, or representatives for any medical treatment, product, or course of action.

orm, or during discussions and presentations (both verbal and written) are not intended as health care recommendations or medical advice by Cancer Patient Lab/Prostate Cancer 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.

SUMMARY KEYWORDS patients, data, treatment, psa, cancer, brian, biomarker, rick, mike, mets, systemic therapy, google drive, alterations, oncologist, lab, insights, database, therapy, tumor, working SPEAKERS Kevin Fordney, Mike Yancey, Saed Sayad, Rebecca Driscoll, Brad Power, Brian McCloskey, Rick Stanton Brad Power We're approaching the one-year anniversary of the Prostate Cancer Lab, which we started in March of last year.

It's very appropriate to take stock and see what we've learned and the community that we have built. Brian will share some analysis he's been doing. I want to qualify this. This is the first time that we've shared this. It's a very rough draft. Please think of it not as a finished product. It's just a working document. Our request is that you help us make it better.

If there are questions and things that you think we should be doing, that's the spirit with which we will be sharing.

“Comparing Test Results and Treatment Strategies across 10 Advanced Prostate Cancer Patients” (Brian McCloskey) [#45] Brian McCloskey 01:35 Thanks everybody for joining. I'm going to have a riveting presentation today. Honestly, it's going to be a little bit more of a weather report than anything.

The reason I say that is that as I was exploring and aggregating this data, I remembered my days when I was working in business intelligence and realized that there was a paradigm, which was 80% of the work is in data aggregation and maybe the other 20% is in analytics, or 10% in analytics and then 10% in decision making.

Over the course of the past several few days, I realized that that 80% rule is 100% accurate. It goes to the point that everything that we're doing right now is manual. As we have the president of AWS with us here wearing his shirt, hopefully we'll be able to get to a much more automated process to look at our data. This is very much a crawl, walk, run approach and we're in a crawl stage.

“Comparing Test Results and Treatment Strategies across 10 Advanced Prostate Cancer Patients” (Brian McCloskey) [#45] So let me share with you what I have. First off, we have 10 patients. One of them wasn't pictured here, but we have 10 patients that are part of the Prostate Cancer Lab. The way that we set this up is that each of the patients is sharing their electronic medical record information and their genomic reports, or "omics" reports, to a Google Drive. I've taken that Google Drive

wasn't pictured here, but we have 10 patients that are part of the Prostate Cancer Lab. The way that we set this up is that each of the patients is sharing their electronic medical record information and their genomic reports, or "omics" reports, to a Google Drive.

I've taken that Google Drive and looked across each of the various patients, and I use a checklist to make sure their documents are complete. This could become the basis for an analytic tool, but I'm exploring their genomics, primary tumor RNAseq, data from their met tumor, insights from liquid biopsies, germline tests, and other tests such as ARV-7, HLA, IHC, etc.

I'm also looking at their electronic medical records. Everyone has some report, whether it's from MD Anderson, UCSF, or wherever, and all of that information is in the Google Drive. I have a section around treatment options.

As you know, we have a marketplace of very generous service providers such as CureMatch, Massive Bio, xCures, Cancer Commons, SHEPHERD Therapeutics, Genomic Expression, CRI, mProbe, and hopefully some others. You're going to see how each patient is tracking through the funnel. Each one of these cells is hyperlinked to the document in the Google Drive.

This is the process in terms of how I was looking across our datasets. This is as basic as you can possibly get, as we're using Excel, Google Drive, and we're not using any kind of analytic tool to connect the data. This is just a starting point. But sometimes when you get your hands dirty, you begin to understand how this information can come together with more sophisticated tools.

This is very much a "crawl, walk, run" process.

“Comparing Test Results and Treatment Strategies across 10 Advanced Prostate Cancer Patients” (Brian McCloskey) [#45] One of the tools that I found yesterday was this cool mapping software, and I wanted to take a look at where all of our patients are. We're all connected, and we are coast to coast, from sea to shining sea. I have pictures for all our patients except for Phil Resch.

There are going to be some data gaps in the data here. We have good coverage of the United States, but hopefully, we're going to be able to fill in all the states and get greater representation across the country. We also want to get more ethnic diversity in our group. If you know people that want to join us, please refer them to us.

We've already had a little bit of word-of-mouth marketing, but continue to do that, particularly if you know African Americans. As many of you may know, African Americans have much higher rates of prostate cancer relative to their population than other racial groups. This is a big focus of the Prostate Cancer Foundation and the American Cancer Society.

We need to reflect that in our community as well.

“Comparing Test Results and Treatment Strategies across 10 Advanced Prostate Cancer Patients” (Brian McCloskey) [#45]

r population than other racial groups. This is a big focus of the Prostate Cancer Foundation and the American Cancer Society. We need to reflect that in our community as well.

“Comparing Test Results and Treatment Strategies across 10 Advanced Prostate Cancer Patients” (Brian McCloskey) [#45] One of the things I wanted to look at was how our patients are moving through what I would call our treatment funnel. As I mentioned, our objective is to integrate electronic medical record information and multiomic insights to guide treatment decisions.

If we look at how our patients are moving through that process, we have 10 patients, and the good news is all of them have some electronic medical record information. All of that is integrated into our Google Drive. All of them have some genomic information. We're doing well in terms of collecting the datasets that are required to get treatment decisions.

If you look at the Prostate Cancer Lab treatment options, this is the aggregation of all our service providers (e.g., xCures, Cancer Commons, CureMatch, etc.) and the patients that have taken advantage of those services. About half of them have varying degrees. Of those five, two have had guided treatment decisions from that insight.

If we pull back a little bit, I think that there's some low hanging fruit. Because we have this data, it's easy to leverage it. Low hanging fruit would be going after Cancer Commons, xCures, Massive Bio and CureMatch. The reason I say that is that their processes to ingest information are very simple. All our patients have the data that's required to feed them.

There's really no reason why that number of five shouldn't be ten. I know that it can be sometimes daunting to pull all this information together and have conversations and start these processes. I would offer that if you need my help to do that, I've done it for other folks, I'd be happy to do it for you.

But it is important because what we're trying to do is elevate the conversation between the patient and the care provider. There are two ways that we do that. One is through these Wednesday sessions, where we offer essentially master classes on cutting-edge science.

The second way that we facilitate that conversation, or raise the water level of intelligence, is to offer these treatment opportunities. I can tell you, as I've gone through this process, that it really is very, very helpful. I think you guys have heard that I went into my oncologist and presented 21 different treatment options aggregated across our service providers.

My med oncologist went through 21 of them, whittled them down to eight, and then finally to three, and now we're about ready to pull the trigger on one of those.

“Comparing Test Results and Treatment Strategies across 10 Advanced Prostate Cancer Patients” (Brian McCloskey) [#45] process, but I understand that there's a lot going on just to manage your disease. I'm happy to