# Genomics-driven precision medicine for advanced pancreatic cancer: early results from the COMPASS trial

Source: https://onco.cc/key-papers/paper-aung-compass-early-results-ccr-2018/  
OnCo record `paper-aung-compass-early-results-ccr-2018` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

COMPASS showed that a fresh biopsy of advanced pancreatic cancer can be whole-genome and RNA sequenced fast enough to report before the first scan, and that classical-subtype tumours responded to first-line chemotherapy far better than basal-like ones.

## Summary

Patients with advanced pancreatic ductal adenocarcinoma were prospectively recruited before first-line combination chemotherapy; fresh image-guided core biopsies underwent laser capture microdissection, whole-genome and RNA sequencing. Sixty-three patients were biopsied between December 2015 and June 2017; sequencing succeeded in 62 (98%) and 60 (95%), with results reported at a median of 35 days, meeting the feasibility endpoint. Objective responses to first-line chemotherapy were significantly better in the classical RNA subtype than the basal-like (P = 0.004), with the best progression-free survival in classical tumours on modified FOLFIRINOX. GATA6 expression by RNA in situ hybridisation was a robust surrogate for the subtypes. Potentially actionable alterations were found in 30%.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Journal: Clinical Cancer Research
- Year: 2018
- DOI: 10.1158/1078-0432.CCR-17-2994
- Authors: Aung KL, Fischer SE, Denroche RE, et al.
- Findings: Whole-genome and RNA sequencing feasible from biopsies within a median 35 days.; Response to first-line chemotherapy better in classical than basal-like tumours (P = 0.004).; GATA6 in situ hybridisation as a subtype surrogate; actionable alterations in 30%.
- What it means: COMPASS is the prospective evidence that transcriptional subtype predicts chemotherapy response, and it produced the practical GATA6 test that trials now use to stratify.
- Caveats: 63 patients; chemotherapy was not assigned by subtype.; Subtype calls require enough tumour cellularity.

## 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
- PubMed: https://pubmed.ncbi.nlm.nih.gov/29288237/

## Connected records

- cancers: [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/)
- drugs: [FOLFIRINOX / mFOLFIRINOX](https://onco.cc/drugs/folfirinox/)
- institutions: [Ontario Institute for Cancer Research](https://onco.cc/institutions/oicr/), [Princess Margaret Cancer Centre](https://onco.cc/institutions/princess-margaret/)
- journals: [Clinical Cancer Research](https://onco.cc/journals/clinical-cancer-research/)
- terms: [COMPASS: real-time sequencing of advanced pancreatic cancer for treatment selection](https://onco.cc/terms/compass-study-pancreatic/), [GATA6 as the marker of classical versus basal-like pancreatic cancer](https://onco.cc/terms/gata6-classical-basal-marker/)

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