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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.
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%.
COMPASS is the prospective evidence that transcriptional subtype predicts chemotherapy response, and it produced the practical GATA6 test that trials now use to stratify.
Shares COMPASS: real-time sequencing of advanced pancreatic cancer for treatment selection, GATA6 as the marker of classical versus basal-like pancreatic cancer, Ontario Institute for Cancer Research, Princess Margaret Cancer Centre.
Shares COMPASS: real-time sequencing of advanced pancreatic cancer for treatment selection, GATA6 as the marker of classical versus basal-like pancreatic cancer, Ontario Institute for Cancer Research, Princess Margaret Cancer Centre.
Shares Clinical Cancer Research, FOLFIRINOX / mFOLFIRINOX, RNA sequencing & expression profiling, Pancreatic ductal adenocarcinoma.
Shares COMPASS: real-time sequencing of advanced pancreatic cancer for treatment selection, GATA6 as the marker of classical versus basal-like pancreatic cancer, FOLFIRINOX / mFOLFIRINOX, Metastatic pancreatic ductal adenocarcinoma.
Shares COMPASS: real-time sequencing of advanced pancreatic cancer for treatment selection, GATA6 as the marker of classical versus basal-like pancreatic cancer, Whole-exome & whole-genome sequencing, Pancreatic ductal adenocarcinoma.
Shares Ontario Institute for Cancer Research, Princess Margaret Cancer Centre.
Shares Clinical Cancer Research, RNA sequencing & expression profiling, Pancreatic ductal adenocarcinoma.
Shares Ontario Institute for Cancer Research, Princess Margaret Cancer Centre.