{"entity":{"id":"paper-aung-compass-early-results-ccr-2018","kind":"paper","name":"Genomics-driven precision medicine for advanced pancreatic cancer: early results from the COMPASS trial","aka":[],"tldr":"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%.","asOf":"2026-09-24","links":[{"label":"Aung et al., Clin Cancer Res 2018: COMPASS, real-time whole-genome and RNA sequencing of 63 advanced patients","url":"https://doi.org/10.1158/1078-0432.CCR-17-2994"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/29288237/"}],"tags":[],"related":[],"cancers":["pancreatic","metastatic-pdac"],"sections":[],"technologies":["wes-wgs","rna-seq"],"targets":[],"drugs":["folfirinox"],"companies":[],"institutions":["princess-margaret","oicr"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["clinical-cancer-research"],"dependsOn":[],"notes":[],"journal":"Clinical Cancer Research","year":2018,"doi":"10.1158/1078-0432.CCR-17-2994","pmid":"29288237","authors":"Aung KL, Fischer SE, Denroche RE, et al.","paperType":"translational","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%."],"whatItMeans":"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."],"changedPractice":false,"participants":63},"route":"/key-papers/paper-aung-compass-early-results-ccr-2018/","neighbours":{"cancer":[{"id":"metastatic-pdac","kind":"cancer","name":"Metastatic pancreatic ductal adenocarcinoma","route":"/cancers/metastatic-pdac/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"technology":[{"id":"rna-seq","kind":"technology","name":"RNA sequencing & expression profiling","route":"/technologies/rna-seq/"},{"id":"wes-wgs","kind":"technology","name":"Whole-exome & whole-genome sequencing","route":"/technologies/wes-wgs/"}],"drug":[{"id":"folfirinox","kind":"drug","name":"FOLFIRINOX / mFOLFIRINOX","route":"/drugs/folfirinox/"}],"institution":[{"id":"oicr","kind":"institution","name":"Ontario Institute for Cancer Research","route":"/institutions/oicr/"},{"id":"princess-margaret","kind":"institution","name":"Princess Margaret Cancer Centre","route":"/institutions/princess-margaret/"}],"journal":[{"id":"clinical-cancer-research","kind":"journal","name":"Clinical Cancer Research","route":"/journals/clinical-cancer-research/"}],"term":[{"id":"compass-study-pancreatic","kind":"term","name":"COMPASS: real-time sequencing of advanced pancreatic cancer for treatment selection","route":"/terms/compass-study-pancreatic/"},{"id":"gata6-classical-basal-marker","kind":"term","name":"GATA6 as the marker of classical versus basal-like pancreatic cancer","route":"/terms/gata6-classical-basal-marker/"}]}}