Summary

Significant progress has been made in the treatment of cancer through the use of targeted drugs, but what works for one patient may not work for another. Cancer cells typically have changes in their genes that make them different from normal cells, and targeted drugs take advantage of these differences to target the cancer cells. Biomarkers are specific characteristics of cancer cells, such as mutations in their DNA, that help doctors identify which drug treatments are likely to be effective or how likely a cancer is to spread.

Our study, called the Ontario-wide Cancer TArgeted Nucleic acid Evaluation (OCTANE), tests archival tumor samples (previously collected biopsy or surgical tumor samples) to provide biomarker data about a patient's cancer. This information may help physicians in guiding the use of approved treatments that may benefit their patient as well as identifying which clinical trials of new drug treatments may be most appropriate for the patient in the future. This study has developed a province-wide registry of results from targeted gene testing, which has been made available to cancer researchers. Additional tumor tissue and blood samples collected from all study participants are stored in a biobank for future research.

Please navigate to the Scientific Research section to learn more about cancer genomics and molecular profiling.

Sawtooth picture with text of Clinical NGS TEsting, Annotated Research Repository, and Development of Future Clinical Tests

OCTANE 1.0

Stage 1 of the OCTANE study aims to expand next-generation sequencing (NGS) panel testing of tumor tissue for cancer patients across Ontario while building a rich biobank (storage of tumor tissue, blood and other biological samples) for future research.

To date, we have enrolled more than 5000 patients with advanced cancers at multiple hospitals in Ontario. Tumor tissues from these patients were sent to labs for testing to detect changes in their DNA (genomic testing). Doctors then used these test results to guide treatment decisions. For example, breast cancer patients found to have a BRCA1 or BRCA2 mutation on OCTANE went on to be treated with Olaparib on a separate study. Similarly, those found to have a CDKN2A mutation went on to receive Palbociclib. Countless mutations have been identified through OCTANE testing, which has allowed some patients to receive treatment tailored to them.

Recruitment Status: Recruiting

Study Start Date: August 2016

Last Updated: March 9, 2023

OCTANE 2.0

For the second stage of our study, OCTANE 2.0, we are researching two big issues:

Why cancer returns (relapses)
How it stops responding to a treatment that may have worked in the past

Molecular residual disease (or MRD) refers to small amounts of cancer cells that remain in the body after surgery to remove the primary tumor. MRD may not be visible with imaging tests, such as CT or MRI, but can be detected with sensitive laboratory techniques that measure small fragments of DNA shed by cancer cells into the bloodstream (circulating tumor DNA, or ctDNA).

We plan to use computer models that are based on information from MRD (ctDNA results) and imaging tests (looking at the shape, size, and texture of the tumor) to help predict which treatments will be helpful and find patients who are at high risk of having their cancer return. The hope is that this will allow doctors to treat cancers much earlier before they relapse, and spread to other parts of the body.

Approximately 460 new patients with specific cancer types will be enrolled to the second stage of OCTANE. These patients will be approached to take part in our study before they start drug treatment or after surgery to remove their cancer. We will collect blood samples during treatment and follow-up along with CT or MRI scan images that doctors use to monitor treatment response and identify when cancer recurs. We will track ctDNA levels from these blood samples and use computer-based models to combine these results with the imaging scans to develop tools that can help doctors identify MRD and provide a window to intervene earlier with curative treatments before relapse occurs.

Recruitment Status: Recruiting

Study Start Date: February 15, 2023

Last Updated: March 9, 2023

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