Fine needle aspiration (FNA) plays a vital role in the evaluation of patients with thyroid nodules, in terms of distinguishing benign, non-neoplastic thyroid nodules that may be conservatively managed from neoplastic or malignant nodules that need surgical intervention. However, a definitive, cytologic diagnosis cannot be rendered in approximately 1/3 thyroid nodules. This session will review updates and challenges associated with assessment of thyroid FNAs.

Learning Objectives

At the end of this presentation, the participants will be able to:

• Review updates in the 2023 Bethesda System for Reporting Thyroid Cytopathology (TBSRTC)
• Recognize cytomorphology patterns of thyroid FNA
• Identify pitfalls and challenges in thyroid FNA cytology
• Discuss the role of ancillary tests as adjuncts to cytologic assessment of thyroid nodules.

Prostate cancer is the most common cancer in men and is second most common cause of cancer deaths. Importantly, the annual rates of prostate cancer incidence continue to rise. 

This session will delve into how pathology, genomics and biomarkers guide the management and treatment of prostate cancer and equip you with a comprehensive understanding of this cancer.

Learning Objectives

At the end of this presentation, the participants will be able to:

• Distinguish between normal prostate tissue and various histological subtypes of prostate cancer.
• Grasp the significance of Gleason grading and Gleason Grade Groups and other prognostic factors in prostate cancer.
• Demonstrate role of immunohistochemistry and other advanced diagnostic techniques.
• Review the timing and role of molecular testing
• Discuss the role of biomarkers in guiding immunotherapy (IO), antibody-conjugated drugs (ADC) and radio-ligand therapies (RLT)
• Identify how pathological assessment drives clinical decision-making
• Define how biomarkers guide treatment

A comprehensive exploration of the latest advancements in the pathology of renal tumors. This one-hour webinar will explore the intricacies of renal tumor pathology, focusing on recent developments in the classification of renal tumors, histopathology diagnostic challenges, and emerging trends in the field.

Whether you're a seasoned pathologist, pathology assistant, or medical professional seeking to expand your knowledge, this webinar offers a unique opportunity to stay abreast of cutting-edge advancements in renal tumor pathology.

Learning Objectives:

• Gain insights into the histopathological classification and subtyping of renal tumors, including recent updates and revisions.
• Understand the diagnostic criteria and challenges associated with differentiating between benign and malignant renal tumors.
• Explore the role of immunohistochemistry and molecular testing in refining the diagnosis and prognostication of renal tumors.
• Discuss emerging trends and novel approaches in the pathological assessment of renal tumors, including the evaluation of tumor heterogeneity and microenvironment.
• Learn about the implications of pathological findings on treatment decisions and patient outcomes in the management of renal tumors.

The practice of diagnostic pathology has gone through a disruptive transformation in which multiple tools such as digital imaging, advanced artificial intelligence algorithms, and computer-aided diagnostic techniques are resulting in the availability of these new tools to assist, augment and empower the diagnostic pathology. Automated whole slide imaging (WSI) scanners are now rendering diagnostic quality, high-resolution images of entire glass slides and combining these images with innovative digital pathology tools that are making it possible to integrate imaging into all aspects of pathology reporting including anatomical, clinical and molecular pathology. The recent approvals of WSI scanner for primary diagnosis by FDA as well as the approval of prostate AI algorithm has paved the way for starting to incorporate this exciting technology for use in primary diagnosis Once the slides are digitized, artificial intelligence tools are providing a unique platform for innovations and advances in anatomical and clinical pathology workflows. This talk will describe where we are in the journey towards utilizing these digital pathology and AI tools for routine pathology practice and what are the possibilities, once fully implemented.

Learning Objectives

At the end of this presentation, the participants will be able to:

1. Provide an overview of digital pathology and AI and how it can help increase our diagnostic accuracy and efficiency
2. Explain the role of digital pathology and AI in optimizing our efficiency.
3. List applications of digital pathology and AI-enabled workflows in routine diagnostic pathology and discuss future directions

In recent years, small volume biopsies have been increasingly utilized for diagnosis of tumors in both primary and recurrent settings.  Concomitantly, the numbers of ancillary studies for characterizing tumors and biomarker tests to support appropriate therapy selection are also on the rise.  A combination of both cytologic and small histologic samples is often obtained in tandem at time of biopsy.  Pathologists are responsible for ensuring judicious selection of specimens appropriate for particular tests in a wide array of tumor types.  This session will review optimal small biopsy utilization for diagnosis and ancillary testing in several organ systems.

Learning Objectives

• Review characteristics of fine needle aspiration and core biopsy samples.
• Understand the advantages and limitations of small samples for diagnosis.
• Understand appropriate sample selection for ancillary testing for diagnostic purposes.
• Understand appropriate sample selection for biomarker assessment.

Join our exclusive webinar, "Revolutionizing Solid Tumor Management: Unleashing the Potential of Liquid Biopsy" for a comprehensive exploration of the groundbreaking world of liquid biopsy in cancer diagnosis and treatment. This session is your opportunity to delve into the key aspects of liquid genomic profiling and its implications for both pathologists and oncologists.

What You'll Learn:
Pathology Perspective: Discover the critical need for genomic testing in cancer and explore the differences between traditional tissue biopsies and liquid genomic profiling. We'll dive into the technical aspects, including Variant Allele Frequency (VAF), Tumor Fraction (TF), and the potential challenges such as false negatives. From the pathology standpoint, we'll walk you through the steps involved in molecular profiling and reporting, shedding light on the laboratory processes and communication of results.

Oncology Perspective: Learn how genomic testing is revolutionizing cancer treatment. Understand how circulating tumor DNA (ctDNA) analysis is applied across various stages of cancer, from late-stage disease management to early- stage detection, screening, risk stratification, and surveillance. From the oncology standpoint, we'll guide you through the steps involved in the practical application of liquid biopsy results in clinical decision-making, including the use of targeted therapies.

Whether you're a healthcare professional, researcher, or simply interested in the future of cancer diagnostics and treatment, this webinar is your gateway to staying informed and up-to-date in this rapidly evolving field. Don't miss this opportunity to expand your knowledge and network with fellow enthusiasts in the world of liquid biopsy. Join us and be a part of the future of cancer care.

Gynecologic cancers account for nearly 40% of all cancer incidence and >30% of all cancer mortality in women worldwide. In recent years, there have been significant advancements in the classification of gynecologic tumors as well as the refinement of biomarker testing of prognostic and therapeutic significance. Human papillomavirus testing, DNA mismatch repair, HER2 and PD-L1 testing and homologous recombination testing have all seen advancements in recent years. It is the combination of an accurate histopathologic diagnosis and biomarker status that ensures timely and optimal therapy for each patient with gynecologic cancer.

Learning Objectives: 
• Review indications for biomarker testing in gynecologic cancers 
• Describe the current prognostic and predictive biomarkers in gynecologic pathology 
• Review guidelines for testing and interpretation of prognostic and predictive biomarkers in gynecologic cancers 
• Summarize challenges in biomarker testing in gynecologic pathology

Breast cancer is the most common cancer diagnosed in women and the second leading cause of female cancer death in the United States. In the last 25 years, the number of therapeutic options for breast cancer has increased, improving survival for breast cancer patients. Selecting appropriate targeted therapy for breast cancer patients starts with pathology. The pathologic diagnosis and testing for breast biomarkers, estrogen receptor, progesterone receptor, and HER2, are essential for determining the need for additional tumor testing and for selecting appropriate therapy that will give each breast cancer patient the best chance at improved survival. 

Learning Objectives:

• Classify breast cancer based on biomarker status. 
• Associate targeted therapies for breast cancer with the pathways driving tumor growth that these drugs block. 
• Identify key items in the pathology report that are important for selecting appropriate therapy and ordering additional tests for breast cancer. 
• Review challenges that pathology faces, past and present, in breast cancer testing. 

The practice of pathology is rapidly undergoing a transformation in which multiple tools such as digital imaging, advanced artificial intelligence algorithms, and computer-aided diagnostic techniques are being linked with molecular pathology resulting in increased diagnostic power based on the ability of modern-day pathologists to use these new tools and to interpret the data generated by them. 

Automated whole slide imaging (WSI) scanners are now rendering diagnostic quality, high-resolution images of entire glass slides and combining these images with innovative AI-based decision support tools that are making it possible to integrate imaging into all aspects of pathology reporting including anatomical, clinical and molecular pathology. The recent approvals of WSI scanner for primary diagnosis by FDA as well as the approval of prostate Al algorithm has paved the way for starting to incorporate this exciting technology for use in primary diagnosis Once the slides are digitized, artificial intelligence and computational pathology tools will serve as a platform for innovations and advances in anatomical and clinical pathology in the future. This talk will describe where we are in the journey towards utilizing these tools for clinical diagnostics and what are the possibilities, once fully implemented.

Learning Objectives:

• Outline an overview of the evolution of digital pathology and AI and its current state for clinical diagnostics, research and education
• Identify the challenges and opportunities for implementing digital pathology and AI in the clinical areas using OSU as an example
• Assess the future directions of Digital Pathology /Artificial Intelligence technology’s role in advanced diagnostics

Worldwide gastric cancer is the 5th most common cancer and the 4th leading cause of cancer deaths. Its highest incidence rates are in east Asia and eastern Europe with low incidence rates in North America and Northern Europe. Overall, gastric cancer has a poor prognosis and often demonstrates regional spread to lymph nodes (in about a quarter of the patients) and distant spread (metastatic disease), in about a third of the patients at the time of diagnosis.

Over the past several years, there have been increasing requests for biomarker testing in gastric and gastroesophageal junction (GEJ) adenocarcinomas. The standard first line treatment for patients with locally advanced inoperable or metastatic gastric adenocarcinoma has been chemotherapy, with a median overall survival of 1 year. Combining targeted therapies with chemotherapy can improve survival. In patients with Her2 positive gastric and GEJ adenocarcinoma, trastuzumab has been approved in combination with chemotherapy. In these patients, assessment of HER2 overexpression in the tumor using immunohistochemistry or in-situ hybridization is recommended by the National Comprehensive Cancer Network (NCCN). All patients with newly diagnosed gastric cancer should also undergo biomarker testing for identification of MSI-H/dMMR gastric adenocarcinoma in consideration for administration of immunotherapy. Checkpoint inhibitor therapy is utilized in combination with chemotherapy as first line therapy in some countries, however, efficacy is mainly in patients with a PD-L1 CPS score of 5 or more. For patients who have HER2 negative disease, and who have a PD-L1 CPS less than 5, an emerging therapeutic target is high Claudin-18 isoform 2 (CLDN18.2) expression.

Learning Objectives:

• Describe current recommendations for biomarker testing in gastric and GEJ adenocarcinomas.
• Review guidelines for testing and interpretation of HER2 by immunohistochemistry and in-situ hybridization.
• Review the current recommended guidelines MSI-H/dMMR testing and PD-L1 with challenges in interpretation of scoring
• Describe the utility of CLDN18.2 as a biomarker in the management of gastric and GEJ adenocarcinoma.  

Lung cancer is still responsible for most cancer-related deaths for both genders in the United States. Traditionally, diagnosis and management of patients has been based on tissue biopsy to identify the major lung cancer categories. Although early stages of lung cancer are mainly managed surgically, it has become more evident in the past 10-15 years that the management of metastatic and advanced cases of lung cancer are based on a combination of pathologic findings, molecular profiling and clinical staging. The traditional molecular testing for EGFR, ALK and ROS1 has been expanded in view of newly developed targeted therapies, and the availability of Next Generation Sequencies and liquid biopsies. Immunotherapies targeting the PD-1/PD-L1 are also part of current treatment arsenal available for lung cancer. This presentation will review the recommended molecular testing for lung cancer, biopsy and tissue guidelines as well as current methologies.

Learning Objectives:

• Describe the current recommendations for molecular testing for non-small cell carcinoma
• Review the guidelines for tissue biopsy handling for lung cancer diagnosis and molecular testing
• Review current guidelines for testing and interpretation of companion and complementary PD-L1 by immunohistochemistry
• Summarize recent outcomes of lung cancer patients treated with a precision medicine approach

The field of Precision Medicine is rapidly advancing, revolutionizing cancer diagnostics with molecular biomarkers that enable diagnostic classification, prognostic risk stratification, and therapeutic risk prediction. However, this progress is accompanied by several challenges that demand innovative solutions. This plenary lecture aims to explore the hurdles encountered in Precision Medicine and propose strategies to overcome them.

Learning Objectives:

• Summarize the reasons for growth of Precision Medicine-based testing

• Review challenges that are impacting the growth of Precision Medicine

• Identify opportunities to enhance clinically appropriate testing to enhance the practice of Precision Medicine