# COMPASS: real-time sequencing of advanced pancreatic cancer for treatment selection

Source: https://onco.cc/terms/compass-study-pancreatic/  
OnCo record `compass-study-pancreatic` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

COMPASS was the Canadian study that took a fresh biopsy from people about to start chemotherapy for advanced pancreatic cancer, sequenced the whole genome and RNA within the time of a treatment decision, and showed that the basal-like subtype predicts poor response to first-line chemotherapy.

## Summary

Run from the Ontario Institute for Cancer Research and Princess Margaret Cancer Centre, COMPASS enrolled patients with locally advanced or metastatic pancreatic ductal adenocarcinoma before first-line chemotherapy, took a core biopsy and returned whole-genome and RNA sequencing results in a clinically useful time; the first report covered 63 patients and showed the approach was feasible and that the Moffitt classical and basal-like signatures could be assigned from biopsies (Aung 2018). In 195 patients, basal-like tumours (20%) responded to first-line chemotherapy in 10% against 33%, progressed on modified FOLFIRINOX in 60% against 15% and had median overall survival of 5.9 against 9.3 months; GATA6 in situ hybridisation reproduced the call with sensitivity 89% and specificity 83% (O'Kane 2020). The purified whole genomes from COMPASS and the PanCuRx resection cohort then showed that the subtypes form a continuum set partly by mutant KRAS dosage, with hybrid tumours of intermediate survival (Chan-Seng-Yue 2020). COMPASS is the source of the subtype figures on the record and the reason a GATA6 stain is proposed as a practical subtype test; a prospective subtype-directed trial has yet to change a guideline.

## Fields

- Kind: Term
- Last checked: 2026-09-24
- Also known as: COMPASS trial; COMPASS study; Comprehensive Molecular Characterization of Advanced Pancreatic Ductal Adenocarcinoma for Better Treatment Selection; PanCuRx
- Tags: pancreatic-molecular

## Sources

- Aung et al., Clin Cancer Res 2018: COMPASS, real-time whole-genome and RNA sequencing of 63 advanced patients: https://doi.org/10.1158/1078-0432.CCR-17-2994
- O'Kane et al., Clin Cancer Res 2020: GATA6 and the basal-like subtype in 195 COMPASS patients: https://doi.org/10.1158/1078-0432.CCR-19-3724
- Chan-Seng-Yue et al., Nat Genet 2020: transcription phenotypes driven by genomic events (purified whole genomes): https://doi.org/10.1038/s41588-019-0566-9

## Connected records

- cancers: [Locally advanced unresectable pancreatic ductal adenocarcinoma](https://onco.cc/cancers/locally-advanced-pdac/), [Metastatic pancreatic ductal adenocarcinoma](https://onco.cc/cancers/metastatic-pdac/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- technologies: [RNA sequencing & expression profiling](https://onco.cc/technologies/rna-seq/), [Whole-exome & whole-genome sequencing](https://onco.cc/technologies/wes-wgs/)
- terms: [Classical versus basal-like (squamous) subtypes of pancreatic cancer, and GATA6](https://onco.cc/terms/classical-vs-basal-like/), [GATA6 as the marker of classical versus basal-like pancreatic cancer](https://onco.cc/terms/gata6-classical-basal-marker/), [KRAS allelic imbalance and mutant KRAS dosage in pancreatic cancer](https://onco.cc/terms/kras-allelic-imbalance/)
- key papers: [GATA6 expression distinguishes classical and basal-like subtypes in advanced pancreatic cancer](https://onco.cc/key-papers/paper-okane-gata6-basal-like-compass-ccr-2020/), [Genomics-driven precision medicine for advanced pancreatic cancer: early results from the COMPASS trial](https://onco.cc/key-papers/paper-aung-compass-early-results-ccr-2018/), [Transcription phenotypes of pancreatic cancer are driven by genomic events during tumor evolution](https://onco.cc/key-papers/paper-chan-seng-yue-pancreatic-transcription-phenotypes-nat-genet-2020/)

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