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February 2017

In cancer sequencing, a new lingua franca

February 2017—NGS has taken its NBS, or next big step: a newly published joint consensus guideline on how to interpret and report sequence variants in cancer. With these 20 pages of best practices for making next-generation sequencing a regular part of cancer diagnostics, the field is moving, essentially, from frontier town to gated community.

Guidelines reset horizons of molecular testing in NSCLC

February 2017—It doesn’t happen often. But from time to time, says Gene Finley, MD, director of medical oncology at Allegheny Health Network in western Pennsylvania, a patient who is at death’s door will make such a dramatic recovery with therapy that clinicians refer to it as a “Lazarus effect.”

One bug or prix fixe? Respiratory pathogen testers weigh in

February 2017—With the number of rapid, accurate molecular assays for respiratory pathogens growing, microbiology laboratories have more options than ever. They include, among others, Meridian Bioscience’s Illumigene assays for group A Streptococcus and pertussis and its newest assay, Mycoplasma Direct, as well as Alere’s assays for influenza A/B, respiratory syncytial virus, and Streptococcus on its i molecular platform. No longer are laboratories limited to inaccurate rapid antigen tests, weeks-long culture, or multi-pathogen panels.

OIG warns against selective free labeling services

February 2017—A laboratory’s proposal to provide free labeling services to some of its dialysis center clients poses more than a minimal risk of fraud and abuse, according to an advisory opinion from the Office of Inspector General of the U.S. Department of Health and Human Services.

From the President’s Desk: The deep roots of tall trees, 2/17

February 2017—One of my mentors, Richard E. Horowitz, MD, is thoughtful, perceptive, persuasive, and calmly persistent. He is a pathologist to the core, the physician inseparable from the scientist. When he wants to know something, he asks—and there’s plenty he wants to know. He is an emeritus professor of pathology with a long string of leadership credits, so he knows where to look for answers to deep questions. And his seemingly irrepressible inclination to mentor younger pathologists nurtures pragmatic leaders who can move our specialty forward.

AMP v Myriad: driving or disrupting innovation?

February 2017—The Association for Molecular Pathology belongs to a small and exclusive club of plaintiffs on the winning side of a unanimous U.S. Supreme Court decision. Such a ruling was issued in 2013 in the case of AMP v Myriad Genetics, a suit sponsored by the American Civil Liberties Union with the AMP as lead plaintiff.

In AP systems marketplace, software comes and grows

February 2017—Software for anatomic pathology has evolved mightily since 1987, the year that CAP TODAY set sail on its maiden voyage as a monthly publication. During that year, HL7 was founded and the Co-Path system, then the flagship product of Collaborative Medical Systems, made a terrific splash on the small exhibit floor at the Palmer House Hotel in Chicago.

An unusual BRAF mutation in a patient with melanoma

February 2017—An activating BRAF mutation is found in 40 to 60 percent of melanoma patients. BRAF (B-Raf proto-oncogene) encodes a protein-kinase that activates the MAP kinase/ERK signaling pathway, a pathway that regulates cell differentiation, growth, and survival. Another protein, NRAS, normally activates BRAF. A mutated BRAF, however, can act independently of NRAS and skew cell activity toward growth and survival and away from differentiation.

‘A marriage of virtual and real bronchoscopy’

February 2017—The molecular testing guidelines have been having a significant impact on surgical practices since they were issued, said thoracic surgeon Min Kim, MD, another webinar panelist. As practice at his institution, Houston Methodist Hospital, has evolved, Dr. Kim said, there has been an increasing need for minimally invasive ways of obtaining tissue from lung cancer patients.

Book review: ‘Resource of choice’ for quality management in AP

February 2017—“Quality management” is the practice of continually evaluating, identifying, and improving the diagnostic process. It refers not only to retrospective action taken after mistakes have been made but also to evaluating near misses and opportunities for improvement in every facet of practice.

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