Comprehensive Molecular Characterization of Advanced Pancreatic Ductal Adenocarcinomas (PDAC) for Better Treatment Selection: A Prospective Study (The COMPASS Trial)

Aim/goals:

The COMPASS Trial was designed to leverage recent and novel discoveries of potential benefit to PDAC patients. This high content, ambitious molecular profiling study has multiple objectives, including feasibility of whole genome and RNA sequencing prepared from laser-captured microscopy to enrich cellularity of small biopsies from patients with advanced PDAC, analysis of standard first line response/failure ‘omics’ subtypes, and selection of ‘biomarker directed’ subsequent line therapies. COMPASS has been focused on some of the key Scientific Questions of MOHCCN, specifically evaluating the clinical validity and utility of genomics for real-time clinical decision making, with molecular tumor board decisions before patients complete 6-8 weeks of 1st-line chemotherapy. Findings lead to chemotherapy switches (HRD status) or planned targeted 2nd-line options. Paired samples from surgical, baseline and treatment progression explore the determinants of treatment failure of immunotherapy/precision cancer medicine as well as investigate temporal and spatial heterogeneity. COMPASS is also focused on elaborating rarer subtypes of HRD phenotype and other potential targets.

Summary:

COMPASS involves comprehensive, real time genomic analysis of advanced PDAC (metastatic and locally advanced) tumors, using the whole genome and RNA sequencing for a clinically meaningful turnaround time. This means any genetic discoveries that may be found have the potential to impact treatment decisions for participating patients, increasing their eligibility for clinical trials and finding the best treatment for their subtype. More globally, the COMPASS dataset has been shared with over 75 collaborating investigators around the world. This rich dataset will contribute to a deeper understanding of the biology of pancreatic cancer leading to more innovative therapeutics for patients now and in the future.