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In this episode, Dr. Monika Lamba, a pathologist from Q² Solutions, discusses the transformative role of digital pathology in clinical trials. Despite its origins aiming to streamline trials, it's not yet the default. Dr. Lamba explores its evolution from telepathology and its integration into trials. The conversation covers challenges in trial organization, patient matching, and the crucial role pathology plays in eligibility, engagement, and consent. Pathology's significance in patient stratification, randomization, and outcome evaluation is highlighted, showing how it guides precision medicine and targeted therapies.
Monika Lamba, MD, Ph.D. is a pathologist-scientist with 15+ years of experience and proficiency in the diagnosis of benign and malignant diseases of different organs, both by cytology and histopathology, incorporating morphology, immunohistochemistry, FISH, cytogenetics and molecular studies. She has extensive experience with clinical trials and is passionate about the digitization of pathology, and algorithm development for image analysis. She has published in well-known medical journals, is a peer reviewer of national and international scientific publications, and is an invited speaker on various international platforms. Professional interests include translational research, transduction pathways, cancer biology, immunopathology, digital pathology, AI, medical writing/ publications, and public speaking.
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In this episode Dr. Monika Lamba Saini and Bruno Larvol of “LARVOL & Friends” discuss the role of artificial intelligence (AI) in pathology and its potential impact on healthcare.
They delve into the slower adoption of AI in pathology compared to other medical specialties and examine the challenges that lie ahead. The conversation explores the need for regulatory approval, integration with hospital systems, and standardization of AI solutions in pathology. Dr. Saini shares insights on image recognition, the digitization of healthcare, and the transformative potential of AI in diagnostic algorithms.
Listen to gain a deeper understanding of the future possibilities of AI in pathology and its implications for precision medicine.
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In this episode, Megan McCausland, Scientific Advisor for Flow Cytometry at Q2 Solutions, and Scott Bornheimer, Associate Director of Medical and Scientific Affairs at BD Biosciences talk about the enormous potential of flow cytometry as a clinical diagnostic tool.
Currently, pharma companies are looking for simplified, standardized flow cytometry tests to help with enrolling patients and understanding outcomes in their studies.
In the longer term, Megan McCausland notes what will lead to the use of flow as a CDx:
“I think the drug development landscape really continues to evolve towards more personalized medicine. As this happens, biomarkers and their potential translation into companion diagnostics are playing an ever-increasingly important role. The regulatory bodies are pushing, perhaps even expecting, this co-development of biomarkers and treatments with CDx really becoming vital to regulatory approval and clinical use.” - Megan McCausland
To learn more visit q2labsolutions.com/flow-cytometry
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With fewer people covering more roles with less specialization and novel therapeutics with unique testing requirements, the needs of small biotech companies in clinical trials are different from larger sponsors.
In this episode, Alex Watt, Global Head for Biotech Integrated Laboratory Solutions and Mona Henderson, Director of Laboratory Network Solutions (both at Q2 Solutions) discuss how our dedicated biotech teams focus specifically on the unique needs of those customers.
Alex and Mona cover:
Operational strategy, from supply chain to data managementThe role of LNS in contracting and managing specialty, third-party labsCollaboration with our parent company, IQVIA andAdapting to evolving customer strategiesYou can learn more at https://q2labsolutions.com/biotech.
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In this episode, Alex Watt, Global Head for Biotech Integrated Laboratory Solutions and Alan Wookey, Global Head of Companion Diagnostics discuss how to manage both scientific and operational risk in clinical trials for biotech companies.
Looking at risk as uncertainty reveals not only threats to project timelines but also opportunities to take a new approach.
Alex and Alan talk about:
How different risks are evaluated and prioritized and the processes put in place to mitigate and/or respond to those risks if they occur. What sponsors can do to reduce the risks for their studyHow Q2 Solutions' in-house scientific and regulatory expertise ensure that your data are compliant to global regulationsYou can learn more at https://q2labsolutions.com/biotech.
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Alex Watt is the Global Head for Biotech Integrated Laboratory Solutions at Q2 Solutions. In this episode, the first of a three-part series, he talks about how biotech companies can best prepare for testing with a CRO or clinical trial.
First it's important to understand you analytical needs. What services are needed to operationalize the study design?Second is data, How will the data generated be used?Third is logistics and supply chain. How does sample get to the analytical location and then to its final destination?Alex goes in depth on each of these and also highlights a number of items that can be overlooked and cause delays as well as what is an appropriate lead time to begin conversations with your vendor to meet your company's timeline.
You can learn more at https://q2labsolutions.com/biotech.
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Becoming bilingual in bioanalysis
In this podcast Barry Jones (Director, LC–MS Biologics and Biomarkers at Q² Solutions) and Adriane Spytko (Manager, LC–MS Biologics at Q² Solutions; both NY, USA) discuss hybrid assays using both LBA and LC−MS techniques. They share their thoughts on bottom-up LC−MS methods and the concern about detecting analyte that is not intact as well as future projects that bridge LC−MS and LBA.
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Most clinical trials involve a variety of laboratory vendors and CROs to provide services during the course of the study. Disparity in how each vendor handles, tracks and reports its data can present a challenge.
In this episode, Barbara Nagaraj, Senior IT Architect at Biofortis, a Q2 Solutions company, describes those challenges and how to mitigate them by asking the right questions in advance.
She talks about:
The need to harmonize data moving between systemsHow to approach vendors of different sizes and capabilitiesThe best time to engage a vendor about data managementQuestions to be answered in negotiationsA success story that save a lot of time and effortTo learn more, visit www.q2labsolutions.com/labmatrix
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Taking an assay from bench to an automated platform
In this podcast, Prakash Bhosale (Director of Discovery ADME at Q2 Solutions; IN, USA) discusses high-throughput in vitro screening and how to understand structure-activity relationships against ADME properties. The advantages of the Tecan technology are also addressed as well as top tips for driving SAR analysis.
Questions discussed include:
Why is compound management and storage important?Do you suggest that a lab goes full in on automation or transitions to automation over time?When do you take an assay from the bench to an automated platform?How much experience do you need with programming to implement automated tools?What are the advantages of the Tecan technology?What are your top tips for driving SAR analysis? -
In this podcast interview, Jason Evans (Scientist at Q² Solutions) discusses the importance of automation and key advantages of taking an assay from the bench to an automated platform. He also explains the increase in throughput when his lab transitioned to automated assays and the hurdles he faced when automating assays.
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Tracking patient consent for the use of their samples in clinical trials is essential to both minimize risk of non-compliance and maximizing potential for future use. In this episode, Barbara Nagaraj, Sr. IT Architect at BioFortis, a Q2 Solutions company, explains informed consent for patient samples and the importance of easily tracking consent as samples move through the clinical trial ecosystem.
She describes:
How consent is or has been documentedThe benefits of electronic consent documentationSpecific consent attributes, e.g. genetic testingHandling consent requirements from different countries or institutionsUnderstanding consent for future use, including limitations and expirationsLearn more at https://www.q2labsolutions.com/labmatrix
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The clinical trial ecosystem is a complex web of investigator sites, laboratories, couriers, patient samples and more. The ability to track those samples though this ecosystem with full visibility for the sponsor is essential for a successful trial. In this episode, Barbara Nagaraj, Sr. IT Architect at BioFortis, a Q2 Solutions company, describes that ecosystem and the lifecycle of patient samples.
She describes:
The varying approaches of small vs. large laboratoriesRisks of insufficient trackingTracking consent for future useCurrent practice and opportunities for improved trackingLearn more at https://www.q2labsolutions.com/labmatrix
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In this episode, Charlie Fix, Global Director of Scientific Harmonization for Q Squared Solutions describes the challenges of safety testing for drugs in pediatric patients where sample volumes may be limited.
Clinical analyzers are set up to maximize throughput and minimize turnaround time. When a panel of multiple tests is ordered and a sample doesn't have a sufficient volume of blood to run all the tests in the panel, the test is canceled, resulting in no data for the sponsor and unnecessary stress for young patients and their families.
Q Squared Solutions has developed a protocol prioritizing a subset of tests for short samples. The decision to run the alternate panel is made by licensed medical technologists. Combined with specific sample collection kits for pediatric patients, this protocol minimizes the number of canceled tests.
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In this episode, Dr. Robert Bailer, Senior Director for Vaccines at Q2 Solutions, describes the processes for testing vaccines against the novel coronavirus, SARS-CoV-2. He covers both ELISA and virus neutralization assays.
Q2 Solutions has developed an ELISA assay to evaluate multiple different antigens at the same time. Looking primarily at the spike protein, it is dissected into different parts: S1, S2, S1 plus S2, and the receptor binding domain. The nucleocapsid protein is being evaluated as well.
We are taking a 2 pronged approach to the viral neutralization assays, working in collaborations with academic institutions to deliver a cutting edge approach.
The first, in collaboration with the laboratory Dr. Pei-Yong Shi at the University of Texas Medical Branch in Galveston, involves viral-like particles (VLPs) where the structural genes of wild type SARS-CoV-2 virus are removed and replaced with a reporter gene. In this particular case, it's a GFP or green fluorescent protein gene along with a neomycin resistance gene.
The second approach is a SARS Co-V 2 surrogate neutralization assay used under a license agreement with the Albert Einstein College of Medicine. This is the vesicular stomatitis pseudovirion process, commonly used for viral neutralization assays. It’s a different way of expressing an artificial virus. It involves taking the vesicular stomatitis virus genome, replacing some of the genes for VSV by inserting the SARS-CoV-2 spike genes, plus a reporter gene. Expressing that produces a virus-like particle or a pseudovirion that can be utilized. This approach has been used over the years in a wide variety of different applications at Q2 Solutions for example in Ebola.
The vaccine operation at Q2 Solutions has the infrastructure, the capabilities and support to have a three shift operation. We anticipate doing this 24/7, which is exactly what’s needed in the context of a pandemic. Further, our center for vaccine excellence located in Beijing, China will evaluate clinical trial samples coming to us there with the same repertoire of assays that are available in San Juan Capistrano, California. The Q2 Solutions model is that we provide answers globally and with high throughput.
Learn more at Q2labsolutions.com.
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In this episode, Drs. Steven Lowes and Barry Jones discuss hybrid assays, combining immuno-affinity with liquid chromatography-mass spectrometry (LC-MS). This is a growing area of opportunity for protein bioanalysis.
Topics covered include:
What is meant by hybrid assayReasons to choose a hybrid assayTop down vs bottom upSpecific challengesAssay design considerationsFuture potential for this type of bioanalysis...I think that fundamental point about more sensitivity, and associated with that is more selectivity, is going to be part of the future adoption of these hybrid assays. We have needs already, we can see needs for looking at quantifying proteins in very small samples, say tissue biopsies. - Steven Lowes
Learn more at Q2labsolutions.com.
Protein Biomarker Quantification by Immunoaffinity Liquid Chromatography–Tandem Mass Spectrometry: Current State and Future Vision (Article in Clinical Chemistry)
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ADME testing (Absorption, Distribution, Metabolism and Excretion) is an essential part of early stage drug development. In this episode, Dr. Matt Hutzler, Director of ADME Services at Q2 Solutions, describes the common paradigm of ADME testing and why short turnaround times are important.
Because speed is so important, outsourcing testing overseas may not make as much economic sense as it might have in the past, given shipping costs and the possibilities for delays (at customs for example.)
Dr. Hutzler explains the factors that contribute to the success of high-throughput ADME testing and what advances and innovations we might expect in the future.
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A liquid biopsy is a minimally invasive alternative to a more traditional surgical solid tumor biopsy.
In this episode, Dr. Stephanie Hastings, genomics product lead at Q Squared Solutions, lays out the considerations for liquid biopsy collection and the type of information that can be gathered from circulating free DNA (cfDNA).
The main approaches comprise for evaluating cfDNA are:
specific mutation detection to help support targeted therapiesbroader sequencing technologies to enable biomarker evaluationscustom sequencing panels to support clinical trial assay developmentShe describes the typical panels for each of the approaches, the sample collection requirements and how these analyses are implemented on a global scale.
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In this episode, Dr. Wayne Hogrefe and Dr. Pat Hurban discuss the use of NGS in the development and assessment of new vaccines against the influenza virus.
Topics covered include:
What health organizations are looking for that drives the selection of the next season's vaccine strainsHow sequence data is used to evaluate the effectiveness of a vaccine while providing insight into the evolution of the virusHow the sequence data can inform the development of new types of vaccines and therapeuticsThe prospects for a vaccine that is effective across multiple strains and multiple seasonsHow NGS data differs from traditional Sanger sequencing data and what can be learned from thatYou can learn more about this topic at www.q2labsolutions.com
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In this episode, Victor Weigman, Director of Translational Genomics at Q Squared Solutions and Mark Stewart, Vice President of Science Policy at Friends of Cancer Research (FOCR) joined to talk about standardization of TMB measurements by alignment to reference standards.
TMB differs from other biomarkers such as PDL1 in that:
"...we're leveraging next generation sequencing to generate a composite score from tens of thousands or in some cases millions of bases of sequence. So really you're summarizing this collection of mutations in a singular value versus a more qualitative range of expression levels done by looking at proteins in a microscope. - Victor Weigman
One challenge is that as treatments are being developed, the thresholds for the diagnostics are out of sync. Friends of Cancer Research understands the difficulty of harmonizing assays to a standard after FDA approval. For that reason, there is strong interest in harmonizing the results of different assays to a standard reference set.
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Mark Edinger is the Scientific Advisor for Flow Cytometry at Q2 Solutions. In this episode, he describes recent advances in flow cytometry and what that means for immuno-oncology trials.
New instruments, reagents and software are enabling researchers to monitor 30-some markers simultaneously to get a better picture of the tumor micro-environment and the interactions taking place.
For example, there's a whole list of new checkpoint inhibitors, like PD-1, CTLA-4, CD-1-52 and a multitude of other CD-47 that have been described, and their ligands on T cells and immune cells, not just T cells, that allows the tumor to actively turn off the host response to the tumor that prevent the tumor from being killed by the immune system. We weren't aware of these, many of these, until we had the tools that allow us to look at many more markers simultaneously. For instance markers of T cell activation have been around for a long time, but that list has expanded remarkably now, and the lists of markers of T cell exhaustion have really expanded as well, and some of those were not discovered until relatively recently, in the last 5 or 6 years.
Mark explained how flow cytometry is being used to determine whether a therapeutic is efficacious or not and the benefits that flow to the patient.
He stressed, as others in this series have, the importance of early engagement between sponsors and their clinical trials partners. Regular phone calls and direct conversations between scientists help refine the assays to produce the desired result in terms of the information collected from a panel.
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