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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.
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.
Showing the technology this term belongs to: Whole-exome & whole-genome sequencing.
It is the number behind 'basal-like is chemoresistant' and the validation of the GATA6 stain that lets a pathology laboratory call the subtype without RNA sequencing.
It explains why single-sample classifiers disagree on about one tumour in eight and why KRAS allelic imbalance and GATA6 copy number are being read alongside expression.
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 Pancreatic ductal adenocarcinoma and the tag pancreatic-molecular.
Shares Pancreatic ductal adenocarcinoma and the tag pancreatic-molecular.
Shares Pancreatic ductal adenocarcinoma and the tag pancreatic-molecular.
Shares Pancreatic ductal adenocarcinoma and the tag pancreatic-molecular.
Shares KRAS allelic imbalance and mutant KRAS dosage in pancreatic cancer, Transcription phenotypes of pancreatic cancer are driven by genomic events during tumor evolution, Whole-exome & whole-genome sequencing, Pancreatic ductal adenocarcinoma.
Shares Genomics-driven precision medicine for advanced pancreatic cancer: early results from the COMPASS trial, GATA6 expression distinguishes classical and basal-like subtypes in advanced pancreatic cancer, Transcription phenotypes of pancreatic cancer are driven by genomic events during tumor evolution, Whole-exome & whole-genome sequencing.
Shares KRAS allelic imbalance and mutant KRAS dosage in pancreatic cancer, Whole-exome & whole-genome sequencing, Pancreatic ductal adenocarcinoma.
Shares KRAS allelic imbalance and mutant KRAS dosage in pancreatic cancer, Transcription phenotypes of pancreatic cancer are driven by genomic events during tumor evolution, Pancreatic ductal adenocarcinoma.