Colorectal Cancer Metastatic Clinical Trial
Official title:
The Oncopanel Pilot (TOP) Study
The BCCA Oncopanel is a clinical assay being developed to determine genotype status of a
prospectively defined set of genes.
The purpose of this pilot study is to assess the feasibility and effect on
clinical-decision-making of the Oncopanel test. Eligible patients are those with advanced
lung, colorectal, melanoma and GIST cancers and patients with diagnosed malignancies being
considered for clinical trials.
Somatic mutations in solid tumors represent an established means of characterizing
malignancies for prognostic, diagnostic and therapeutic purposes. Mutations in EGFR, KRAS,
BRAF, and KIT and PDGFRA genes direct therapy in patients with advanced lung, colorectal,
melanoma, and GIST tumors, respectively. Known or novel mutations in other genes may also be
of clinical significance but are not identified by current genotyping offered to BC Cancer
Agency (BCCA) patients. Furthermore, numerous candidate genes have been implicated as
potential prognostic and predictive biomarkers in patients with solid tumours. As such, the
Oncopanel is a clinical assay being developed to determine genotype status of a
prospectively defined set of genes. The following clinically relevant set of genes and exons
are included in the Oncpanel: KRAS, EGFR, BRAF, NRAS and HRAS, PIK3CA Signal Transduction
Pathway Genes, RAS-RAF-MEK-MAPK Pathway, HER2, IDH1 and IDH2, ALK, TP53, c-KIT, STAT1&3 and
PDGFRA. Additional testing on the tumour material will also include analysis of specific
gene variants associated with adverse events or response to therapy.
Numerous studies have documented the presence of circulating tumour DNA (ctDNA) among
patients with advanced and early stage malignancies (20-22). The ability to diagnose
standard cancer mutations with a blood-based assay (a "liquid biopsy") has not yet been
established but presents obvious advantages. The emergence of "resistance" mutations arising
in the metastatic tumor or throughout the course of therapy is well documented (21, 22). A
blood biopsy may represent more accurate determination of the tumor's genetic features than
archival DNA specimen. Adequate tissue specimens can be difficult to obtain from some
patients with diagnosed malignancies, particularly lung cancer. A blood biopsy may represent
a less invasive and timelier means of diagnosing both standard and translational cancer
mutations.
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