OCTANE 2.0 – serial liquid biopsies and radio-genomics to identify early markers of adaptive resistance or relapse
What we do?
The Ontario-wide Cancer Targeted Nucleic acid Evaluation (OCTANE) 2.0 study, helps cancer doctors find the best treatment for each patient. We do this by looking at certain features in a patient’s genes, called biomarkers, that are located within their cancer. These features can tell doctors which treatments may work best for that patient.
Why we do it?
Everyone’s cancer is different, so what works for one patient may not work for another.
In OCTANE 2.0, we are researching two big issues: why cancer returns and how it stops responding to a treatment that may have worked for a patient in the past.
We hope that cancer doctors can use the information from our research to detect cancer earlier and recommend the best targeted therapies for their patients. Targeted therapies are treatments that are designed for a person’s specific type of cancer cells.
Early detection and treatment are important because they can prevent cancer from returning and spreading to other parts of the body.
How we do it?
Cancer patients from multiple hospitals across Ontario are asked to take part in our study before they start drug treatment or after surgery to remove their cancer. We collect blood samples and CT/MRI images at various points during a patient’s treatment. If the cancer returns or gets worse, we may also collect a small sample of the cancer that has returned or gotten worse.
One of the main reasons we collect blood is to look for molecular residual disease (or MRD). MRD refers to small amounts of cancer cells that remain in the body after surgery to remove the main tumour. MRD may not be visible with imaging tests, such as CT or MRI scans, but can be detected with sensitive laboratory instruments. These instruments measure small bits of DNA that have been left behind by cancer cells and are circulating in the bloodstream.
Our project will use computer models that bring together information from MRD tracking and imaging tests to help predict which treatments are most likely to work and to find patients who are at high risk of having their cancer return.
About our Project:
Molecular profiling is the testing of cancer cells for genetic mutations. By understanding specific mutations in a given patient’s cancer, clinicians will be better equipped to predict tumour behaviour and then select individualized therapies for each patient. Molecular profiling early in the course of treatment may also allow for more efficient screening of patients for clinical trials with matched targeted therapies.
The Ontario-wide Cancer TArgeted Nucleic acid Evaluation (OCTANE) study is an Ontario Institute for Cancer Research (OICR)-supported initiative that provides next generation sequencing (NGS)-based molecular profiling at multiple Ontario cancer centres, including the Juravinski Cancer Centre, London Health Sciences Centres, The Ottawa Hospital, Kingston General Hospital and the Princess Margaret Cancer Centre. OCTANE 1.0 enrolled more than 4,000 patients with advanced cancers at seven academic hospitals in Ontario for genomic testing, or analysis of specific DNA mutations in their cancers. These analyses were used to inform the patient’s oncologists on recommended drug treatments.
OCTANE 2.0 will build upon this successful Ontario-wide network to develop computational tools to more accurately predict whether drug treatments will be effective and identify patients at increased risk of relapse. OCTANE 2.0 will sequence the entire DNA from tumour and normal cells, and assess the presence and quantity of RNA, the molecule that carries the message between DNA and proteins in cancer cells, from selected patients enrolled in OCTANE 1.0. Scans performed during a patient’s routine care will be gathered and specific features of these scans (radiomics) extracted to build computational models that combine this genomic and imaging data. OCTANE 2.0 will also enroll 650 patients across Ontario with specific cancer types and collect i) serial blood samples during treatment or follow-up to evaluate circulating tumour DNA (small fragments of DNA from cancer cells shed into the bloodstream); ii) CT or MRI scans used to monitor their treatment; and iii) biopsies if their cancer relapses or progresses.
This project aims to integrate molecular data with imaging data to aid development of computational tools and predictive models for aiding clinical decision making.
If successful, these prediction models may be used to more accurately predict whether drug treatments are likely to be effective and to identify patients at increased risk for relapse, so patients can be given the best treatment option.
Cancer Genomics Program
Dr. Philippe Bedard
Dr. Benjamin Haibe-Kains