Biomarkers In Oral CANcer (BIO-CAN)

Aim/goals:

1. To collect and analyze “gold-standard” clinical data elements and samples for –omic and molecular analyses of patients prospectively recruited and followed longitudinally up to 2 years post-treatment.
2. To improve our understanding of how clinico-pathological characteristics and –omic/molecular markers are related to heterogeneous prognostic outcomes, including cancer recurrence and survival.
3. To develop genomic biomarkers that can enhance clinical decision-making.

Summary:

Every year, an estimated 5400 Canadians are diagnosed with oral cavity squamous cell cancer (OCSCC); 1500 Canadians will die from OCSCC, as OCSCC presents numerous challenges to clinical management. Although the majority of patients present with local or regional disease and are eligible to be treated for cure, 5-year survival remains low, at around 50%, despite the use of intensive multimodal therapy; after initial surgical resection and based on clinical and pathological features, adjuvant radiotherapy concurrent chemoradiotherapy is often used. The decision to administer adjuvant therapy does not currently account for molecular features of the tumor. As a result, some patients are overtreated, resulting in unnecessary morbidity and societal costs, while other patients are undertreated and eventually relapse, having not received optimal management.

Within Canada and abroad, the Biomarkers In Oral CANcer (BIO-CAN) cohort (2007-present) is a uniquely rich resource that has enabled our multidisciplinary research team to study the biology and genomics of OCSCC. Specifically, we are investigating the impact of temporal and spatial heterogeneity on cancer recurrence risk, and we are evaluating the clinical validity and utility of genomics for real-time clinical decision making. Patients receiving standard-of-care therapy are consented for -omic/molecular analysis of tumor/normal paired fresh frozen and FFPE samples, serial liquid biopsy blood collection, tissue microarrays, patient-derived xenograft (PDX) generation, detailed epidemiological risk information, serial patient-reported outcome data, and detailed clinical, treatment, and outcome data. This work has resulted in stored biospecimens and clinically annotated data from over 1,000 OCSCC patients.