Study of Changes and Characteristics of Genes in Patients With Pancreatic Cancer for Better Treatment Selection (COMPASS)

• Sponsor: University Health Network, Toronto
• Information provided by (Responsible Party): University Health Network, Toronto

Study Description

Brief Summary:

Researchers are looking for better ways of understanding and treating pancreatic cancer. The purpose of this study is to see how useful it is to look for changes and characteristics in your genes (molecules that contain instructions for the development and functioning of the cells) and the genes within the tumour. These characteristics may be useful in choosing treatments for patients in the future. Changes (mutations) in genes have been shown to be an important characteristic in cancers. Looking at differences in genes in patients with advanced pancreatic ductal adenocarcinomas and comparing this information with response to their initial chemotherapy treatment may help to learn which treatments may be better for certain patients after initial treatment.

Condition or disease	Intervention/treatment
Carcinoma, Pancreatic Ductal	Genetic: Molecular Profiling

Study Design

• Study Type: Observational
• Estimated Enrollment: 180 participants
• Observational Model: Cohort
• Time Perspective: Prospective
• Official Title: Comprehensive Molecular Characterization of Advanced Pancreatic Ductal Adenocarcinomas (PDAC) for Better Treatment Selection: A Prospective Study
• Study Start Date: December 2015
• Estimated Primary Completion Date: February 2021
• Estimated Study Completion Date: December 2021

Groups and Cohorts

Group/Cohort	Intervention/treatment
Patients with advanced pancreatic ductal adenocarcinoma	Genetic: Molecular Profiling; Whole Genome Sequencing

Outcome Measures

Primary Outcome Measures :

1. The feasibility of prospectively identifying subgroups of patients with advanced PDAC who have distinct genomic characteristics for better treatment selection while undergoing 1st-line chemotherapy using next generation sequencing. [ Time Frame: 8 weeks ]

Secondary Outcome Measures :

1. Disease control rate achieved by m-FOLFIRINOX [ Time Frame: 5 years ]
2. Disease control rate achieved by nab-paclitaxel [ Time Frame: 5 years ]
3. Duration of response defined as the interval between the first date of complete response or partial response and the earliest date of disease progression or death due to any cause to m-FOLFIRINOX [ Time Frame: 5 years ]
4. Duration of response defined as the interval between the first date of complete response or partial response and the earliest date of disease progression or death due to any cause to nab-paclitaxel. [ Time Frame: 5 years ]
5. Progression free survival defined as the interval between the date of registration and the earliest date of disease progression or death due to any cause of patients treated with m-FOLFIRINOX. [ Time Frame: 5 years ]
6. Progression free survival defined as the interval between the date of registration and the earliest date of disease progression or death due to any cause of patients treated with nab-paclitaxel. [ Time Frame: 5 years ]
7. Overall survival defined as the interval between the date of registration and the date of death of patients treated with m-FOLFIRINOX [ Time Frame: 5 years ]
8. Overall survival defined as the interval between the date of registration and the date of death of patients treated with nab-paclitaxel. [ Time Frame: 5 years ]
9. Correlation between tumor genomic characteristics and m-FOLFIRINOX response using next generation sequencing. [ Time Frame: 5 years ]
10. Correlation between tumor genomic characteristics and nab-paclitaxel response using the next generation sequencing. [ Time Frame: 5 years ]
11. Percentage of patients with germline BRCA, PALB2 and ATM mutations who might benefit from a personalized treatment strategy such as combination of cisplatin and a PARP inhibition. [ Time Frame: 5 years ]
12. Percentage of patients with somatic DSBR deficiency who might benefit from a personalized treatment strategy such as combination of cisplatin and a PARP inhibitor. [ Time Frame: 5 years ]
13. Percentage of patients who might benefit from immunotherapy (patients with smoking genomic signatures, patients with a hypermutated phenotype, patients with mismatch repair deficiency and patients with tumor neo-antigen expression). [ Time Frame: 5 years ]
14. Percentage of patients with rare but targetable somatic mutations. [ Time Frame: 5 years ]
15. Difference in disease control rate between patients with tumor smoking signature and those without. [ Time Frame: 5 years ]
16. Difference in overall survival between patients with tumor smoking signature and those without. [ Time Frame: 5 years ]
17. Correlation with tumor molecular characteristics and toxicities to treatment using next generation sequencing. [ Time Frame: 5 years ]

Biospecimen Retention:   Samples With DNA

• Fresh tumor tissue biopsy samples
• Archival tumor tissue samples
• Whole blood samples
• Plasma samples
• Serum samples

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No
• Sampling Method: Probability Sample

Study Population

Locally advanced or metastatic pancreatic ductal adenocarcinoma

Criteria

Inclusion Criteria:

• Patients must have a histological or radiological diagnosis of locally advanced or metastatic pancreatic ductal adenocarcinoma. Patients with borderline resectable disease are not eligible.
• Patient must have a tumor lesion that is amenable to a core needle biopsy.
• Patients must have a measurable lesion by RECIST 1.1 in addition to the lesion that is going to be biopsied.
• Patients must be fit enough to safely undergo a tumor biopsy.
• Age 18 years or older.
• Eastern Cooperative Group (ECOG) performance status of 1 or less.
• Life expectancy of greater than 90 days.
• Patients must have normal organ and marrow function
• Patients must undergo systemic treatment with m-FOLFIRINOX or nab-paclitaxel as a first line standard systemic palliative treatment or combination treatment with m-FOLFIRINOX or nab-paclitaxel with or without other investigational agents within a clinical trial as a first line palliative treatment.
• Ability to understand and willing to sign a written informed consent document.

Exclusion Criteria:

• Patients with one or more contraindications to tumor biopsy.
• Patients who have prior systemic treatment (chemotherapy or any other anti-cancer agent) in advanced setting.
• Patients who are currently on anti-cancer treatment including chemotherapy.
• Patients with known brain metastases.
• Patients with advanced PDAC who are going to be treated with gemcitabine monotherapy in advanced setting.
• Uncontrolled inter-current illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
• Any other condition that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns or compliance with clinical study procedures.

Contacts and Locations

Contacts

Contact: Jennifer J. Knox, M.D; 416-946-2399

Locations

Canada, Ontario

Kingston Health Sciences Centre; Recruiting

Kingston, Ontario, Canada, K7L2V7

Contact: Jim Biagi, M.D. 613-549-6666 ext 8105

Princess Margaret Cancer Centre; Recruiting

Toronto, Ontario, Canada, M5G 2M9

Contact: Jennifer J. Knox, M.D. 416-946-2399

Principal Investigator: Jennifer J. Knox, M.D.

Canada, Quebec

McGill University Health Centre; Recruiting

Montréal, Quebec, Canada, H4A3J1

Contact: George Zogopoulos, M.D. 514-934-1934 ext 76333

Sponsors and Collaborators

University Health Network, Toronto

Investigators

• Principal Investigator: Jennifer J. Knox, M.D.; Princess Margaret Cancer Centre

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Aung KL, Fischer SE, Denroche RE, Jang GH, Dodd A, Creighton S, Southwood B, Liang SB, Chadwick D, Zhang A, O'Kane GM, Albaba H, Moura S, Grant RC, Miller JK, Mbabaali F, Pasternack D, Lungu IM, Bartlett JMS, Ghai S, Lemire M, Holter S, Connor AA, Moffitt RA, Yeh JJ, Timms L, Krzyzanowski PM, Dhani N, Hedley D, Notta F, Wilson JM, Moore MJ, Gallinger S, Knox JJ. Genomics-Driven Precision Medicine for Advanced Pancreatic Cancer: Early Results from the COMPASS Trial. Clin Cancer Res. 2018 Mar 15;24(6):1344-1354. doi: 10.1158/1078-0432.CCR-17-2994. Epub 2017 Dec 29.

• Responsible Party: University Health Network, Toronto
• ClinicalTrials.gov Identifier: NCT02750657 History of Changes
• Other Study ID Numbers: COMPASS-001
• First Posted: April 25, 2016
• Last Update Posted: February 4, 2019
• Last Verified: January 2019

Additional relevant MeSH terms:

Carcinoma, Pancreatic Ductal; Carcinoma, Ductal; Adenocarcinoma; Carcinoma; Neoplasms, Glandular and Epithelial; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Ductal, Lobular, and Medullary; Pancreatic Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Endocrine Gland Neoplasms; Digestive System Diseases; Pancreatic Diseases; Endocrine System Diseases