Precision Cancer Medicine

PrecisionCancerMedicineLarge.jpgDrs. Lillian Siu and Philippe Bedard have been leading the drive to integrate molecular profiling into cancer diagnosis and treatment planning, for nearly a decade. It’s part of their commitment to advancing precision cancer medicine for patients in Canada and around the world.

“Not all cancers that look the same under the microscope have the same patterns of genetic mutations,” explains Dr. Bedard.
Creating a personalized tumour profile can identify treatment options much more quickly and precisely; in some cases, it allows clinicians to avoid therapies that are unlikely to be successful or those which could cause significant side effects. That was the basis for a pair of large sequencing trials initiated by Drs. Siu and  Bedard back in 2012.

The Integrated Molecular Profiling in Advanced Cancer Trial (IMPACT) and Community Oncology Molecular Profiling in Advanced Cancer Trial 
(COMPACT) provided doctors in the Greater Toronto Area with biomarker information so that each patient’s treatment could be tailored to his or her specific form of the disease. The results from the first 1,800 patients showed tumours shrank in a small proportion of patients who were matched to clinical trials based on profiling. The purpose of the team’s latest study is to roll out these findings across the province.

“We’ve recently opened up a trial called OCTANE,” says Dr. Bedard. The Ontario-wide Cancer Targeted Nucleic Acid Evaluation (OCTANE) is designed to expand the use of next-generation sequencing (NGS) technology in Ontario cancer centres. The Princess Margaret is leading the trial, with four other centres coming online this year in Hamilton, London, Ottawa, and Kingston.

Tumour samples from patients across Ontario 
will be analyzed at participating centres and the results shared on a secure genomic data platform. Oncologists will be able to use the information to identify the most appropriate clinical trials or drug treatments for their patients.

“Through this study we are not only providing access to novel treatments to benefit patients but we are establishing a research infrastructure that will advance the use of personalized medicine in Ontario,” says Dr. Siu.