Advanced Incurable Cancers Clinical Trial
Official title:
Utilization of Genomic Information to Augment Chemotherapy Decision-making for People With Incurable Malignancies
Most systemic therapies are chosen on the basis of large randomized clinical trials; however, tumour heterogeneity means that cancers with similar histological features may have substantially different underlying biological drivers. The investigators propose that applying personal genomic information prospectively obtained in a clinically realistic timeframe to assist in chemotherapy decision-making could result in more effective and efficient cancer treatment. This study will investigate this approach in a cross section of advanced cancers to examine timeliness, deliverability, rate of actionable targets identified, and our ability to expand this approach into a larger clinical trial setting.
It is clear that carcinogenesis is an immensely complex process and that even within a
histologic cancer subtype - such as adenocarcinoma of the lung or breast - there is
significant heterogeneity in cancer behaviour and response to therapy. Recognizing genetic
mutations that promote disease facilitates targeted treatment; this has been demonstrated in
several small subgroups of cancers in which specific genetic mutations or translocations
have been successfully treated with targeted chemotherapy agents.
Analyses of individual patients demonstrate unique molecular signatures for every cancer
examined. Frequently, multiple different pathways are involved in disease growth and
progression and the dominant process varies from person to person and perhaps even within
different sites of disease within one person. As well these variations evolve in response to
treatment. With many recognized mutations personalized evaluation of the genetic signature
encoded in DNA and RNA may enable directed therapy to the appropriate oncologic pathway
thereby providing information to help guide chemotherapy choices.
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Intervention Model: Single Group Assignment, Masking: Open Label