Liquid biopsies are becoming increasingly used for the detection and monitoring of disease states. While cell free DNA (cfDNA) in blood and urine have been well studied, much less is known about the composition of cfDNA in seminal fluid. We sought to characterize cfDNA in seminal fluid through tissue of origin studies using methylation analysis in men aged 21-60 yrs. We confirmed the observations of others that seminal fluid contains an abundance of cfDNA that is both nucleosomal and > 1 kb. However, here we demonstrate for the first time that the high molecular weight (HMW) DNA harbors a lower sperm signal and higher somatic cell signal compared to the nucleosomal fraction. Prostate, granulocytes and kidney showed a mean predicted increased contribution of 6.2%, 4.9% and 2.9%, respectively in the HMW fraction. While sperm was the predominant signal in most men without vasectomies, granulocyte cfDNA made up most of the signal in two of the non-vasectomy subjects. Unexpectedly, the proportion of prostate signal reached as high as 26.5% in the HMW fraction in non-vasectomy subjects. We also observed subject-specific cfDNA size distribution patterns that were reproducible over time, irrespective of abstinence times. These results suggest that seminal fluid is a rich source of cfDNA from various somatic cell types, and enriching for the HMW fraction would yield even higher sensitivity for somatic cfDNA detection. Considering these novel findings, it appears that seminal fluid may be able to serve as liquid biopsy for the detection and monitoring of prostate cancer, benign prostate hyperplasia, prostatitis and infertility.
1525 Background: Over 90% of oncologists agree that sperm banking should be offered to all men at risk of subfertility associated with cancer treatment, but fewer than 50% bring up the topic. Barriers cited include lack of time for the discussion, perceived high cost, and lack of convenient facilities. The advent of mail-in semen analysis (SA) testing and cryopreservation may improve access to this service via lower patient cost, decreased required oncologist logistical support, and home rather than local lab collection. That said, average sperm recovery rate after sample thaw is ~50% with immediate banking, and sperm recovery rate after delayed cryopreservation with a mail-in approach remains unknown. Methods: This is a prospective preliminary study assessing freeze-thaw total motile count at 3 time points of cryopreservation: upon receipt of sample, at 24 hours, and at 48 hours post collection. We collected 39 fresh semen samples from 13 healthy adult volunteers. Samples were diluted with 5mL of Fellow Health preservation solution and analyzed (World Health Organization guidelines V5). Samples were divided into 3 aliquots: Aliquot #1, T0 was immediately frozen with equal part cryoprotectant. Aliquot #2, T24 and aliquot #3, T48 were left at room temperature for 24 and 48 hrs respectively, analyzed, and then frozen. Aliquots were then thawed on a heat block at 37C for 10 minutes and analyzed. Results: Baseline SA values were: volume 3.3ml +/- 1.3, concentration 138.3 +/-57.4 x 10 6 , motility 49% +/-6%; Total Motile Count (TMC) 213 +/- 110 million. TMC was the primary endpoint as measured by baseline semen volume, concentration, and motility at 3 time points (T0, T24, T48). The average loss from freeze/thaw in TMC at T0 was 45%, at T24 was 55% relative to T24 pre-freeze, and at T48 was 59% relative to T48 pre-freeze (p = 0.013). On average, samples with starting TMC between 50-100 million had enough motile sperm for six intrauterine insemination (IUI) cycles when frozen and thawed at T0, two at T24, and two at T48. Samples with starting TMC between 100-200 million had enough motile sperm for 16 IUI cycles when frozen and thawed at T0, eight at T24, and four at T48. Samples with starting TMC > 200 million had enough motile sperm for 42 IUI cycles when frozen and thawed at T0, 21 at T24, and nine at T48. All samples had ample viable cells ( > 50,000) at all three time points for in vitro fertilization (IVF). Conclusions: Mail-in cryopreservation using our improved methodology may increase access to this service for oncological patients while still facilitating reasonable assisted reproductive technology care relative to in-person cryopreservation.
e20587 Background: The combined use of molecular biomarker testing and targeted precision therapeutics has led to improved survival in lung cancer. Broadening access to national guideline recommended comprehensive molecular testing requires overcoming the challenges of inadequate tissue biopsies, which can lead to the need for additional procedures and ultimately, delays in initiation of care. We show Percepta Genomic Atlas identifies key molecular alterations in transbronchial needle aspirate (TBNA) and transbronchial biopsy (TBB) samples of lung or lymph node collected during the initial diagnostic bronchoscopy. Methods: Percepta Genomic Atlas combines the whole exome TruSeq RNA Exome and targeted AmpliSeq Focus DNA assays (Illumina) for a comprehensive gene panel including ALK, RET, ROS1, NTRK1/3, MET, EGFR, BRAF, KRAS and HER2. TruSight Oncology 500 DNA and AmpliSeq Focus RNA assays (Illumina) were used as reference assays. DNA and RNA were extracted from samples with the AllPrep Micro kit (Qiagen) and analyzed by Percepta Genomic Atlas and reference assays. 94 biopsy samples (73 TBNA and 21 TBB from 71 patients undergoing a diagnostic bronchoscopy for suspected lung cancer were collected into RNAprotect (Qiagen) under an IRB approved protocol. Local molecular testing results from FFPE biopsy samples taken during the same bronchoscopy procedure were collected. Results: RNA and DNA in sufficient amounts to run the Percepta Genomic Atlas and reference assays was obtained from 85 of 94 lung biopsies from 63 of 71 patients. Percepta Genomic Atlas identified pathogenic variants in 29 bronchoscopy biopsy samples from 23 patients including single nucleotide variants in EGFR, KRAS, BRAF and PIK3CA, an EGFR exon 19 deletion/insertion and copy number amplications in AR, EGFR, CDK4, CCND1, MYC, MYCN and PIK3CA. No fusions were identified. This results in a 100% sensitivity for detecting pathogenic alterations when compared to reference assay results. When comparing Percepta Genomic Atlas results to local molecular testing of bronchoscopy samples performed as part of routine clinical care, we found 100% concordance with 7 of 7 alterations detected in 7 patients, including mutations in EGFR, KRAS and BRAF. In a further 4 patients, Percepta Genomic Atlas and local multi-gene NGS testing results agreed, with neither assay identifying guideline recommended alterations. Conclusions: Using a combination of whole exome RNA and targeted DNA sequencing, Percepta Genomic Atlas detects the clinically actionable mutations in patients with non-small cell lung cancer using fresh tissue specimens collected during bronchoscopic tissue sampling, with high concordance to standard of care testing. By initiating broad molecular testing at the time of the bronchoscopy, Percepta Genomic Atlas may provide timelier results for patients with lung cancer.
Background Bronchoscopy is commonly utilized for non-surgical sampling of indeterminant pulmonary lesions, but nondiagnostic procedures are common. Accurate assessment of the risk of malignancy is essential for decision making in these patients, yet we lack tools that perform well across this heterogeneous group of patients. We sought to evaluate the accuracy of three previously validated risk models and physician-assessed risk (PAR) in patients with a newly identified lung lesion undergoing bronchoscopy for suspected lung cancer where the result is nondiagnostic. Methods We performed an analysis of prospective data collected for the Percepta Bronchial Genomic Classifier Multicenter Registry. PAR and three previously validated risk models (Mayo Clinic, Veteran’s Affairs, and Brock) were used to determine the probability of lung cancer (low, intermediate, or high) in 375 patients with pulmonary lesions who underwent bronchoscopy for possible lung cancer with nondiagnostic pathology. Results were compared to the actual adjudicated prevalence of malignancy in each pre-test risk group, determined with a minimum of 12 months follow up after bronchoscopy. Results PAR and the risk models performed poorly overall in the assessment of risk in this patient population. PAR most closely matched the observed prevalence of malignancy in patients at 12 months after bronchoscopy, but all modalities had a low area under the curve, and in all clinical models more than half of all the lesions labeled as high risk were truly or likely benign. The studied risk model calculators overestimate the risk of malignancy compared to PAR, particularly in the subset in older patients, irregularly bordered nodules, and masses > 3 cm. Overall, the risk models perform only slightly better when confined to lung nodules < 3 cm in this population. Conclusion The currently available tools for the assessment of risk of malignancy perform suboptimally in patients with nondiagnostic findings following a bronchoscopic evaluation for lung cancer. More accurate and objective tools for risk assessment are needed. Trial registration: not applicable.
e20546 Background: Significant progress has been made in improving progression-free survival in lung cancer through the combination of molecular biomarker testing and personalized therapeutics. Broadening access to national guideline recommended comprehensive molecular testing requires overcoming challenges of inadequate tissue biopsies, which can lead to the need for additional procedures and ultimately, delays in obtaining molecular testing. Additionally, there is growing evidence for the use of targeted therapies to treat early stage lung cancer and therefore a need for molecular testing across all stages of lung cancer. We show Percepta Genomic Atlas can identify key molecular alterations in early stage and advanced lung cancers and that it can successfully detect these alterations in surgical lung biopsy (SLB) specimens, transbronchial needle aspirates (TBNA) and bronchial brush specimens obtained during the initial bronchoscopy at the time of diagnosis. Methods: Percepta Genomic Atlas combines the whole exome TruSeq RNA Exome and targeted AmpliSeq Focus DNA assays (Illumina) for a comprehensive gene panel including ALK, RET, ROS1, NTRK1/3, MET, EGFR, BRAF, KRAS and HER2. TruSight Oncology 500 DNA and AmpliSeq Focus RNA assays (Illumina) were used as orthogonal assays. 92 fresh-frozen SLB samples were purchased from BioIVT and biopsies from 25 patients undergoing a diagnostic bronchoscopy during an IRB approved clinical study were collected into RNAprotect (Qiagen). DNA and RNA were extracted from both sample sets with the AllPrep Micro kit (Qiagen) and analyzed by Percepta Genomic Atlas and orthogonal assays. Results: The Percepta Genomic Atlas assay was used to profile small amounts of RNA and DNA from lung cancer SLB tissues, of which 60% were Stage I, 24% Stage II and 16% Stage III. Genomic alterations were observed in 65% of Stage I, 64% of Stage II and 73% of Stage III samples including single nucleotide variants (SNV) in KRAS, EGFR, and PIK3CA, indels in HER2 exon 20, multiple copy number variants, and RET and MET exon 14 skip rearrangements. Percepta Genomic Atlas was used to successfully profile TBNA and bronchial brush specimens providing molecular data from all 25 patients and identifying multiple alterations including KRAS, EGFR and PIK3CA SNVs. Conclusions: Percepta Genomic Atlas detects clinically actionable alterations in both SLB of early stage lung cancer tumors and in specimens collected at the time of diagnostic bronchoscopy or needle aspiration prior to surgery. The early detection of actionable alterations at the time of initial tissue acquisition could minimize need for additional diagnostic procedures and inform earlier treatment decisions with the expanding field of targeted adjuvant therapy.
BACKGROUND:The Percepta genomic classifier has been clinically validated as a complement to bronchoscopy for lung nodule evaluation. RESEARCH QUESTION:The goal of this study was to examine the impact on clinical management decisions of the Percepta result in patients with low- and intermediate-risk lung nodules. STUDY DESIGN AND METHODS:A prospective "real world" registry was instituted across 35 US centers to observe physician management of pulmonary nodules following a nondiagnostic bronchoscopy. To assess the impact on management decisions of the Percepta genomic classifier, a subset of patients was analyzed who had an inconclusive bronchoscopy for a pulmonary nodule, a Percepta result, and an adjudicated lung diagnosis with at least 1 year of follow-up. In this cohort, change in the decision to pursue additional invasive procedures following Percepta results was assessed. RESULTS:A total of 283 patients met the study eligibility criteria. In patients with a low/intermediate risk of malignancy for whom the clinician had designated a plan for a subsequent invasive procedure, a negative Percepta result down-classified the risk of malignancy in 34.3% of cases. Of these down-classified patients, 73.9% had a change in their management plan from an invasive procedure to surveillance, and the majority avoided a procedure up to 12 months following the initial evaluation. In patients with confirmed lung cancers, the time to diagnosis was not significantly delayed when comparing Percepta down-classified patients vs patients who were not down-classified (P = .58). INTERPRETATION:The down-classification of nodule malignancy risk with the Percepta test decreased additional invasive procedures without a delay in time to diagnosis among those with lung cancer.
SESSION TITLE: Wednesday Electronic Posters 3 SESSION TYPE: Original Inv Poster Discussion PRESENTED ON: 10/23/2019 09:45 AM - 10:45 AM PURPOSE: Inconclusive bronchoscopy results occur approximately 40-60% for the evaluation of pulmonary nodules. Very little has been reported on the outcomes of inconclusive bronchoscopy and even less on atypical cell results leaving clinicians in a potential clinical dilemma. It is unclear what the risk of malignancy with atypical cell results is after bronchoscopy. METHODS: A retrospective review of cases with atypical cells from an inconclusive bronchoscopy was examined from the Percepta bronchial genomic classifier multi-center registry. The registry examined inconclusive bronchoscopy results for the evaluation of pulmonary nodules. We collected data on demographics, radiographic characteristics, and pre-test risk assessment for malignancy. All patients had a minimum of 12 month follow-up and adjudication of pathology and imaging. RESULTS: 520 patients enrolled in the PERCEPTA registry with an inconclusive bronchoscopy. 58 (11%) cases were identified with atypical cells on cytology across 18 different medical centers. Of the 58 cases, 17 patients were removed due to lack of follow-up or ineligible for adjudication. Overall, there was a 76% rate of malignancy (OR 5.6, CI 1.19-26.58). In the high risk group (n=18), 94% were eventually found to have malignancy (OR 10.9, CI 1.23-97.04). 62% in the intermediate group (n=35) had malignancy. The low risk group (n=2), 50% had malignancy. CONCLUSIONS: Atypical cells on bronchoscopy may increase the post-test risk of malignancy especially in the high risk group. CLINICAL IMPLICATIONS: Atypical cells on bronchoscopy has not been examined in the United States to our knowledge. Our cohort reports 11% prevalence in a multi-center registry. The findings of atypical cells increases the risk of malignancy especially in the high risk group where it is 94%, consideration should be made to forego additional diagnostic testing if surgery or curative radiation is a potential option. DISCLOSURES: No relevant relationships by Alexa Barriere, source=Web Response Consultant relationship with AstraZeneca Please note: $5001 - $20000 Added 11/29/2018 by David Feller-Kopman, source=Web Response, value=Consulting fee Consultant relationship with Veracyte Please note: $5001 - $20000 Added 11/29/2018 by David Feller-Kopman, source=Web Response, value=Consulting fee Consultant relationship with Veran Medical Please note: $5001 - $20000 Added 11/29/2018 by David Feller-Kopman, source=Web Response, value=Consulting fee Employee relationship with Veracyte, Inc. Please note: $20001 - $100000 Added 03/15/2019 by Bailey Griscom, source=Web Response, value=Salary Consultant relationship with Veracyte Please note: $5001 - $20000 Added 03/18/2019 by Hans Lee, source=Web Response, value=Consulting fee Consultant relationship with Veran medical Please note: $5001 - $20000 Added 03/18/2019 by Hans Lee, source=Web Response, value=Consulting fee Employee relationship with Veracyte Please note: >$100000 Added 03/15/2019 by Lori Lofaro, source=Web Response, value=Salary No relevant relationships by Christopher Mallow, source=Web Response No relevant relationships by Majid Shafiq, source=Web Response No relevant relationships by Jeffrey Thiboutot, source=Web Response Consultant relationship with Veran Please note: >$100000 Added 11/29/2018 by Lonny Yarmus, source=Web Response, value=Grant/Research Support Research relationship with Rocket Medical Please note: $20001 - $100000 Added 06/20/2019 by Lonny Yarmus, source=Web Response, value=Grant/Research
SESSION TITLE: Wednesday Electronic Posters 3 SESSION TYPE: Original Inv Poster Discussion PRESENTED ON: 10/23/2019 09:45 AM - 10:45 AM PURPOSE: Determining pretest probability of malignancy in patients with pulmonary nodules is necessary for accurate application of guidelines for diagnosis and management strategies. The Percepta Bronchial Genomic Classifier relies on pre-bronchoscopy physician assessed risk (PAR) of malignancy to provide a post-test risk. Multiple risk calculators are available using clinical and CT characteristics, or physicians may use intuitive judgment to assess risk. The accuracy of models is influenced by the risk of malignancy in the population used to develop them and relying on a single calculator may reduce their overall effectiveness across populations. This study compares the predictive power of available risk calculators and PAR in a population of patients whose bronchoscopic examination was non-diagnostic for lung cancer at centers throughout the US. METHODS: CT images and PAR of malignancy were collected for 380 patients enrolled across 35 centers at the time of bronchoscopy for evaluation of pulmonary lesions. CT images underwent central panel review to provide standardized nodule characteristics and measurements. Corresponding clinical history and patient outcome data at 12 months was available as part of data collection for an ongoing prospective multicenter Registry for the Percepta test. Centrally reviewed nodule characteristics and clinical history were used as inputs to generate estimated risk of malignancy through multiple risk models: Mayo Clinic, VA (Gould) and Brock. Each risk calculator and PAR were compared to the observed prevalence. Where the observed prevalence did not fall within the range specified for each risk group, a one-tailed p-test was used to determine if observed values was significantly different from the bound of that interval. RESULTS: At 12 months following bronchoscopy, the study population had an overall malignancy prevalence of 32.8%. Observed prevalence in patients by model and predicted risk are as follows: Low risk (60%) PAR 60%, Mayo 34%, Gould 38%, Brock 31%. The observed prevalence for the high-risk group defined using the Mayo, Gould, and Brock models were all determined to be significantly <0.0001). CONCLUSIONS: In this study, PAR most closely matches observed prevalence of malignancy in patients 12 months after bronchoscopy. Evaluated models performed well in the low and intermediate risk groups but underestimated the high-risk group study population. CLINICAL IMPLICATIONS: Risk calculators are helpful for patient management but may not always provide accurate estimates of risk of malignancy. Alternative methods of risk assessment such as physician judgment or discerning calculator selection on a patient-by-patient basis may yield more accurate predictive risk measurements. DISCLOSURES: No relevant relationships by Hitesh Batra, source=Web Response Employee relationship with Veracyte, Inc. Please note: >$100000 Added 03/21/2019 by Janna Chamberlin, source=Web Response, value=Salary Employee relationship with Veracyte, Inc. Please note: $20001 - $100000 Added 03/21/2019 by Janna Chamberlin, source=Web Response, value=Stock holder Consultant relationship with AstraZeneca Please note: $5001 - $20000 Added 11/29/2018 by David Feller-Kopman, source=Web Response, value=Consulting fee Consultant relationship with Veracyte Please note: $5001 - $20000 Added 11/29/2018 by David Feller-Kopman, source=Web Response, value=Consulting fee Consultant relationship with Veran Medical Please note: $5001 - $20000 Added 11/29/2018 by David Feller-Kopman, source=Web Response, value=Consulting fee Employee relationship with Veracyte, Inc. Please note: $20001 - $100000 Added 03/15/2019 by Bailey Griscom, source=Web Response, value=Salary Employee relationship with Veracyte Inc Please note: >$100000 Added 03/15/2019 by Jing Huang, source=Web Response, value=Salary Employee relationship with Veracyte Please note: >$100000 Added 03/18/2019 by Marla Johnson, source=Web Response, value=Salary no disclosure on file for Giulia Kennedy; Consultant relationship with Veracyte Please note: $5001 - $20000 Added 03/18/2019 by Hans Lee, source=Web Response, value=Consulting fee Consultant relationship with Veran medical Please note: $5001 - $20000 Added 03/18/2019 by Hans Lee, source=Web Response, value=Consulting fee Employee relationship with Veracyte Please note: >$100000 Added 03/15/2019 by Lori Lofaro, source=Web Response, value=Salary No relevant relationships by Majid Shafiq, source=Web Response Consultant relationship with Veran Please note: >$100000 Added 11/29/2018 by Lonny Yarmus, source=Web Response, value=Grant/Research Support Research relationship with Rocket Medical Please note: $20001 - $100000 Added 06/20/2019 by Lonny Yarmus, source=Web Response, value=Grant/Research No relevant relationships by Diana Yu, source=Web Response
SESSION TITLE: Advances in the Diagnosis of Lung Cancer SESSION TYPE: Original Investigations PRESENTED ON: 10/09/2018 02:30 PM - 03:30 PM PURPOSE: Bronchoscopy is frequently used for evaluation of pulmonary lesions, but its sensitivity for detecting lung cancer can be limited. A bronchial genomic classifier (Percepta) has been validated as a complement to lung cancer diagnostic bronchoscopy to improve its sensitivity and negative predictive value. When bronchoscopy is inconclusive, Percepta can identify patients who can be considered for CT surveillance instead of undergoing another invasive diagnostic procedure. We report here on the clinical utility of Percepta among patients enrolled in the Percepta Registry at up to 12 months post bronchoscopy. METHODS: Patients were prospectively enrolled at 40 medical centers when Percepta was ordered due to an inconclusive bronchoscopy. The classifier sample was obtained by brushing the right mainstem bronchus during bronchoscopy, regardless of nodule size or location. Pre- and post-classifier clinical management recommendations were recorded and follow-up clinical, procedure, and imaging data were collected. RESULTS: 399 patients had an inconclusive bronchoscopy and were within indication (no prior cancer and current or former smoker). The majority of lesions were <30mm (77%), peripherally located (72%), solid (73%), and upper lobe (55%). Advanced bronchoscopic technologies were used in 68% of cases and PET was used prior to bronchoscopy in 37% of patients. This interim analysis focuses on the 289 patients (72%) with intermediate (245) or low (44) pre-test risk of malignancy. 32% of intermediate pre-test risk patients were down classified by Percepta to low risk, and 52% of low pre-test risk patients were down classified by Percepta to very low risk. These results are consistent with the results from the AEGIS 1 and 2 studies (Silvestri et al, NEJM 2015): 38% and 54% down classification, p = 0.85 and p =0.30 respectively. Among patients where risk of malignancy was down-classified by Percepta, physicians significantly reduced invasive procedure recommendations from 41% to 18% in the intermediate pre-test risk and 9% to 0% in the low pre-test risk group. This results in an overall procedure reduction of 34% to 14% (relative reduction of 59%, p=0.0005). 83% of those who were down-classified remained procedure free at 12 months follow up. CONCLUSIONS: We observed a significant reduction in additional invasive procedures compared to the pre-test management plan for patients who were down classified by Percepta after an inconclusive bronchoscopy. This reduction in procedures has been durable over 12 months. Additional data will help further determine the ultimate clinical utility of the test. CLINICAL IMPLICATIONS: A bronchial genomic classifier can reduce the number of unnecessary invasive procedures that are performed following an inconclusive bronchoscopy for suspect lung cancer. DISCLOSURES: No relevant relationships by Sadia Benzaquen, source=Web Response No relevant relationships by Michael Bernstein, source=Web Response Consultant relationship with Medtronic ILS Please note: $5001 - $20000 Added 02/25/2018 by Krish Bhadra, source=Web Response, value=Consulting fee Advisory Committee Member relationship with Biodesix Please note: $5001 - $20000 Added 02/25/2018 by Krish Bhadra, source=Web Response, value=Consulting fee Consultant relationship with Boston Scientific Please note: $1001 - $5000 Added 02/25/2018 by Krish Bhadra, source=Web Response, value=Consulting fee Consultant relationship with Merit Endotek Please note: $1001 - $5000 Added 02/25/2018 by Krish Bhadra, source=Web Response, value=Consulting fee Consultant relationship with BodyVision Please note: $1001 - $5000 Added 02/25/2018 by Krish Bhadra, source=Web Response, value=Consulting fee Consultant Consultant relationship with Auris Surgical Robotics Please note: $1001 - $5000 Added 03/03/2018 by Krish Bhadra, source=Web Response, value=Consulting fee No relevant relationships by Travis Dotson, source=Web Response No relevant relationships by Mark Esterle, source=Web Response researcher relationship with veracyte Please note: $1-$1000 Added 03/03/2018 by Joshiah Gordon, source=Web Response, value=Grant/Research Support Employee relationship with Veracyte, Inc. Please note: $20001 - $100000 Added 03/05/2018 by Bailey Griscom, source=Web Response, value=Salary Speaker/Speaker's Bureau relationship with Boston Scientific Please note: $20001 - $100000 Added 03/01/2018 by D Hogarth, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with Shire Please note: $5001 - $20000 Added 03/01/2018 by D Hogarth, source=Web Response, value=Honoraria Consultant relationship with Auris Please note: $1001 - $5000 Added 03/01/2018 by D Hogarth, source=Web Response, value=Consulting fee Consultant relationship with Auris Please note: $20001 - $100000 Added 03/01/2018 by D Hogarth, source=Web Response, value=Ownership interest Unrestricted Education Grant relationship with Boston Scientific Please note: $20001 - $100000 Added 03/01/2018 by D Hogarth, source=Web Response, value=Unrestricted Education Grant Consultant relationship with BronchiSense Please note: $20001 - $100000 Added 03/01/2018 by D Hogarth, source=Web Response, value=Ownership interest Consultant relationship with LX Medical Please note: $5001 - $20000 Added 03/01/2018 by D Hogarth, source=Web Response, value=Ownership interest Consultant relationship with Biodesix Please note: $5001 - $20000 Added 03/02/2018 by D Hogarth, source=Web Response, value=Consulting fee Consultant relationship with Body Vision Please note: $20001 - $100000 Added 03/03/2018 by D Hogarth, source=Web Response, value=Ownership interest Consultant relationship with Medtronic Please note: $5001 - $20000 Added 03/03/2018 by D Hogarth, source=Web Response, value=Consulting fee Consultant relationship with Auris Please note: $5001 - $20000 Added 03/03/2018 by D Hogarth, source=Web Response, value=Consulting fee Consultant relationship with Auris Please note: >$100000 Added 03/03/2018 by D Hogarth, source=Web Response, value=Ownership interest Consultant relationship with Preora Please note: $20001 - $100000 Added 03/03/2018 by D Hogarth, source=Web Response, value=Ownership interest Speaker/Speaker's Bureau relationship with Grifols Please note: $20001 - $100000 Added 03/03/2018 by D Hogarth, source=Web Response, value=Honoraria Consultant relationship with Heritage Biologics Please note: $20001 - $100000 Added 03/03/2018 by D Hogarth, source=Web Response, value=Consulting fee Consultant relationship with Boston Scientific Please note: $20001 - $100000 Added 03/03/2018 by D Hogarth, source=Web Response, value=Consulting fee Consultant relationship with Gala Therapeutics Please note: $5001 - $20000 Added 03/03/2018 by D Hogarth, source=Web Response, value=Consulting fee Consultant relationship with Matrix Analytics Please note: $20001 - $100000 Added 03/03/2018 by D Hogarth, source=Web Response, value=Ownership interest Consultant relationship with OncoCyte Please note: $5001 - $20000 Added 03/03/2018 by D Hogarth, source=Web Response, value=Consulting fee Owner/Founder relationship with Medical Opinion Systems Please note: $20001 - $100000 Added 03/03/2018 by D Hogarth, source=Web Response, value=Ownership interest Consultant relationship with Neurotronic Please note: $1001 - $5000 Added 03/03/2018 by D Hogarth, source=Web Response, value=Consulting fee Speaker/Speaker's Bureau relationship with Veracyte Please note: $5001 - $20000 Added 03/03/2018 by D Hogarth, source=Web Response, value=Honoraria Employee relationship with Veracyte Inc Please note: >$100000 Added 03/04/2018 by Jing Huang, source=Web Response, value=Salary Employee relationship with Veracyte Please note: >$100000 Added 03/09/2018 by Marla Johnson, source=Web Response, value=Salary Removed 03/09/2018 by Marla Johnson, source=Web Response Employee relationship with Veracyte Please note: $20001 - $100000 Added 03/09/2018 by Marla Johnson, source=Web Response, value=Salary Employee relationship with Veracyte Please note: >$100000 Added 03/27/2018 by Giulia Kennedy, source=Admin input, value=Salary Consultant relationship with Veracyte Please note: $5001 - $20000 Added 03/09/2018 by Hans Lee, source=Web Response, value=Consulting fee Consultant relationship with Veran Medical Please note: $20001 - $100000 Added 03/09/2018 by Hans Lee, source=Web Response, value=Grant/Research Support Employee relationship with Veracyte Please note: >$100000 Added 03/03/2018 by Lori Lofaro, source=Web Response, value=Salary Advisory Committee Member relationship with Exact Sciences Please note: $1001 - $5000 Added 03/05/2018 by Peter Mazzone, source=Web Response, value=Consulting fee Research support relationship with Veracyte Please note: $5001 - $20000 Added 03/05/2018 by Peter Mazzone, source=Web Response, value=Grant/Research Support Research support relationship with Oncocyte Please note: $5001 - $20000 Added 03/05/2018 by Peter Mazzone, source=Web Response, value=Grant/Research Support Consultant relationship with Veracyte Please note: $20001 - $100000 Added 04/30/2018 by Avrum Spira, source=Admin input, value=Salary Consultant relationship with Janssen Pharmaceuticals Please note: $20001 - $100000 Added 04/30/2018 by Avrum Spira, source=Admin input, value=Consulting fee No relevant relationships by Patrick Whitten, source=Web Response