Cancer Pharmacoepidemiology and Genomics: What You Should Know in the Era of Precision Medicine

This course, co-sponsored by the "Molecular Epidemiology, Biomarkers, and Pharmacogenomics" and "Cancer" SIGs, will focus on the essentials every pharmacoepidemiologist should know about study design, databases and real-world applications of cancer personalized medicine including precision medicine, companion diagnostics, biomarkers and the biomarker development pipeline, diagnosis and treatment coding, drug and cancer risk associations and linking databases with genomic information.

Requisites Statement
Entry level. Attendees should have basic knowledge of pharmacogenomics or have watched the pre-course videos available online:
--The convergence of Pharmacoepidemiology and Precision Medicine [Gillian Bartlett]
--A Primer on Genetic Terms and Basic Concepts [Geoffrey Liu]
--Cancer Terminology and the Science of Cancer Drug Development [Geoffrey Liu]

Course Objectives
--To acquire an overview of genomics in cancer research, and how epidemiologists and real-world studies make contributions.
--To attain a better understand of methodological issues related to pharmacoepidemiology studies of cancer risk.
--To improve an understanding of cancer diagnosis and treatment coding in administrative claims, EHR and clinico-genomic databases.
--To understand better target therapy for application in pharmacoepidemiology cancer research designs and oncology drug development, including the use of biomarkers and companion diagnostics.
--To understand the benefits and challenges of pharmacoepidemiology study designs in oncology research and their impact on clinical practice applications.

Syllabus Outline

Introduction, Format and Objectives of the Course: [Kelly Filipski]
- 5 minutes. Through a series of pre-recorded case study-based lectures (110 minutes in total), this course will enhance your understanding of the important role pharmacoepidemiologist's play in the design, analysis, evaluation, database utilization and interpretation of medication exposure and cancer risk oncology drug development, real-world evidence studies cancer drug effectiveness, and real-world evidence studies of adverse events.

Speakers will start with a case study, and weave their talk through the case study, using the study to introduce key challenges and potential solutions and may include alternative approaches, and individualization based on characteristics of the clinical situation.

Designing and Analysing Pharmacoepidemiology Studies in Cancer Research [Kelly Filipski]
- 20 min will present an introduction to cancer genomics - using both somatic and germline genomic data as examples

Cancer Pharmacoepidemiology and Pharmacogenomics in Oncology Drug Development [Wei Zhou and Leah Sansbury]
-20 minutes will present a case study of the development of an anti-cancer agent. Examples of a case study may include: a PD-1/PD-L1 drug (such as Keytruda) or an anti-cancer targeted therapy or immunotherapy (such as anti-B-Cell Maturation Antigen) or another example chosen by the speakers. Using this case example, we will discuss the epidemiologist's contribution in different phases oncology drug development and includes important study design and evaluation concepts during the oncology drug pipeline with special consideration of pharmacogenomics and target therapy.

Real-World Databases and Cancer Diagnosis and Treatment Coding in Cancer Risk and Treatment Outcome Studies [Donna Rivera]
- 20 minutes will share different approaches and available resources for coding of cancer diagnosis, treatment and recurrence data in administrative claims, EHRs and clinic-genomic databases. Will discuss the advantages, disadvantages and limitations of using different databases for RWE studies for cancer risk, and cancer effectiveness and safety.

Designing Cancer Pharmacoepidemiology-Pharmacogenomics Studies to study Adverse Events [Bruce Carleton]
-20 minutes - will present a case study for the design, analysis and interpretation of an adverse event for an anti-cancer agent. Examples of a case study may include: anthracyclines and cardiotoxicity.· Using this case example, we will provide considerations to how to efficiently approach the study of cancer therapy-induced adverse events with a particular focus on genomics study design, conduct and analysis to be derived from pharmacoepidemiological data and DNA-based genomics analyses. Techniques to use include rapid cycle analysis to identify AEs of concern, case series and verification through medical record review, then genome-wide association studies based on validated phenotypes. This example will help illustrate how the pharmacoepidemiological study of adverse events and pharmacogenomics can help improve the safety of cancer therapy.

Real-World Study Design and Analysis of Cancer Drug Effectiveness [Geoff Liu]
- 20 minutes - will present a case study for the design, analysis and interpretation of the effectiveness of a currently approved anti-cancer agent in different populations or for additional indications. Examples of a case study may include: a PD-1/PD-L1 drug or another anti-cancer targeted or immunotherapy or another example chosen by the speakers. Using this case example, we will provide considerations to how to efficiently approach a real-world evidence study of an approved cancer therapy for effectiveness in different populations, sub-populations and additional clinical indications. There will be a particular focus on design, conduct and analysis, and discuss unique aspects of somatic cancer pharmacogenomics, focusing on somatic biomarkers including mutations, gene or protein expressions.