CHICAGO (GenomeWeb) – Five cancer centers in Ontario kicked off a genomic data-sharing initiative to help match individual patients with targeted therapies and relevant clinical trials.
The Ontario-wide Cancer Targeted Nucleic Acid Evaluation (OCTANE) study brings together the expertise, clinical records, and sequencing data from each cancer center into a database that organizers expect will eventually include hospitals and clinics across Canada's most populous province.
Initial work, organized by the Toronto-based Ontario Institute for Cancer Research, began in November 2016 to build on earlier research on molecular profiling of advanced solid tumors. This was followed by the launch last month of the OCTANE study, a two-year pilot program being conducted by researchers at Princess Margaret Cancer Centre in Toronto, Juravinski Cancer Centre in nearby Hamilton, Kingston Health Sciences Centre, London Health Sciences Centre, and the Ottawa Hospital Cancer Centre.
The researchers are developing a province-wide registry of targeted sequencing test results for the study that will be made available to other cancer researchers. In addition, they will collect tumor tissue and blood samples from study participants for future research at the Princess Margaret-Ontario Institute for Cancer Research Translational Genomics Laboratory, including circulating tumor DNA testing. Specimens are being stored at the Ontario Tumour Bank within OICR.
"OCTANE is part of a data-sharing initiative to bring large numbers of clinical genomes together in one place for the benefit of the cancer research community," said Lincoln Stein, head of adaptive oncology at OICR. "That data is pooled, harmonized, and made available by a nice, friendly web front end to the benefit of all the researchers who are participating in this network," Stein said. "We've designed it so it can grow and we can add more laboratories to it."
Each particular molecular testing lab does its own testing, accredited by the Ontario Laboratory Association. Genomic data is transferred to an instance of the cBioPortal for Cancer Genomics created especially for this study, according to OCTANE Co-principal Investigator Philippe Bedard, a medical oncologist at Princess Margaret.
"The goal is to use some of these research specimens in additional research studies, partly through the Translational Genomics Laboratory at the Ontario Institute for Cancer Research and Princess Margaret. That's a shared initiative," Bedard said.
"In Ontario, these types of tests are not funded routinely outside of specific indications, so it's an opportunity to enable some of the academic labs who have just been starting doing next-generation sequencing panel-based testing to do more of this type of testing and share their data across the province," Bedard said.
On the technical side, clinical data is being stored in a Medidata system installed at Princess Margaret. "We're collecting limited clinical annotation. We're able to migrate that data so it can also appear in the cBioPortal, which the study team has access to across the province," Bedard reported.
OICR is building tools on top of cBioPortal, including what Stein called a "physician's assistant," which provides advice from a curated database, given a specific patient and a set of mutations, on drugs the patient might respond to and what clinical trials might be appropriate. It essentially is clinical decision support for molecular diagnosis and pharmacogenomics.
Success in the pilot phase would mean demonstrating that five independently run cancer centers can successfully share data, according to Stein. "Also, collecting high-quality research samples for future research and having good-quality clinical data. To me, those would be the metrics of success for this pilot phase," Stein said.
"I think for us, at least in this initial phase, [the goal] is first and foremost to show that we can do it, that we can all work together, that we can iron out some of the issues in terms of genomic and clinical data sharing and consent [of] patients for this type of testing," Bedard added.
"The most important thing that we're trying to do is effect a cultural change and demonstrate to the community the power of data sharing," Stein said. "Our initial reactions from the clinical group has been that it's quite wonderful because when they find a variant that they haven't seen before, they can immediately go into the OCTANE database and see if anybody else in the community has seen the same variant." If someone has, a conversation can follow to discuss how to proceed with the patient.
"The most immediate effect is to change the ecosystem from a series of silos where people aren't really exchanging their experiences much to one in which there is this pooling of information, pooling of expertise, and practical knowledge," Stein added.
There are bigger long-term goals, too.
"When the database is large enough, we're hoping to mine it for markers that will predict response and adverse effects, but we have to reach a certain size before we can do that," Stein said. "It's the first step in a much larger and more comprehensive vision of clinical and genomic data sharing."
The five participating cancer centers are in the southern part of the province, because that's where most of the population is. But Ontario covers a vast geographic area, all the way from the St. Lawrence River to Lake Superior, and north to Hudson Bay, so there is plenty of opportunity for future growth.
"We had a lot of interest from other centers who also want to join," Bedard said. "If the study is successful and there's additional support to move forward, I think we would all foresee adding additional sites and building capacity across the province."