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Starting in 2012, medical oncologists at Princess Margaret Cancer Centre enrolled 3,000 patients in a clinical research study that used molecular profiling to analyze individual mutations in cancer tissue from patients with advanced solid tumours.
It was the first time clinical researchers in the cancer program used a panel of 50 genes versus traditional single gene testing to examine mutations. The purpose was to give oncologists more information to direct their patients to new treatments and clinical trials when standard treatments were no longer effective, says co-principal investigator Dr. Philippe Bedard. He talks about the research
Results of the first 1,800 patients enrolled in the trial show that tumours shrank in a small proportion matched to clinical trials based on profiling. The findings were published Oct. 25, 2016 in
"I think we're really at the early stages of using mutation profiles," says Dr. Bedard. "Technology is quickly advancing – just three years later we now have panels of 550 genes – and data-sharing among other large cancer centres that can help accelerate targeted drug development and precision medicine."
The initial study, known as IMPACT – Integrated Molecular Profiling in Advanced Cancers Trial, – involved patients from across UHN. A parallel study was expanded to include other hospitals and was called COMPACT – Community Molecular Profiling in Advanced Cancers Trial.
Dr. Bedard says: "The excitement of IMPACT and COMPACT was that we were able to introduce new technology on a broad scale. We were able to collaborate as oncologists, laboratory physicians and clinical geneticists to generate this type of complex molecular profiling data, including it in the patient's medical record, and use it to guide treatment for a subset of patients.
"It was a success in terms of organizing the infrastructure to do this type of testing and enable us to transition toward the next generation of precision cancer medicine."
Data from the studies are being shared with collaborators at other institutions to continue to better understand mutations in cancer, says Dr. Bedard.
The research was funded by The Princess Margaret Cancer Foundation, Cancer Care Ontario, University of Toronto Division of Medical Oncology and the Ontario Ministry of Health and Long-Term Care.