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IMPACT (Integrated Molecular Profiling in Advanced Cancer Trial) and COMPACT (Community Oncology Molecular Profiling in Advanced Cancer Trial) are two clinical trials being run by the Princess Margaret Cancer Centre that will help advance Personalized Cancer Medicine by basing treatment on the molecular profile of each patient’s tumour.

Launched on March 1, 2012, IMPACT is the first Canadian comprehensive molecular profiling program that seeks to provide doctors with specific cancer gene information so that each patient’s treatment can be tailored to his/her specific form of the disease.

Cancer was once thought of as a single disease that affected many different parts of the body. Researchers now know that the genetic abnormalities that initiate each patient’s cancer are different, even if cancers from the same part of the body may look the same under a microscope. IMPACT is providing molecular information which enables doctors to determine the right treatment for the right patient at the right time.

Led by Drs. Phillipe Bedard and Lillian Siu, the first stage of IMPACT involves patients who are being treated at the Princess Margaret Cancer Centre for advanced breast cancer, colorectal cancer, ovarian cancer and non-small cell lung cancer, as well as those referred for early phase (Phase I) clinical trials. Molecular testing for IMPACT is conducted under the direction of Dr. Suzanne Kamel-Reid and results from the testing are included in the patient’s electronic health record (this permanent record is important as future treatment options become available). The genetic profile for each patient’s tumour is then discussed at multi-disciplinary IMPACT Tumour Board Meetings. Here doctors and researchers gather to provide input from their particular specialties and propose a personalized treatment plan that is tailored to each patient.

The original goal of the study was to profile 500 patients. The response to date has been so positive and overwhelming (close to 400 patients already participating) that the target has now been increased to 1,000 patients. Additional disease sites such as head and neck, pancreatic and biliary are also being considered. The lessons learned in this trial, including new systems, protocols and standards, will be pivotal to the development and expansion of Personalized Cancer Medicine.

COMPACT is the next stage in the evolution of Personalized Cancer Medicine – taking the model out to community partners beyond The Princess Margaret. Like IMPACT, COMPACT will focus on breast, colorectal, ovarian and non-small cell lung cancer, but will involve 500 patients per year being treated at other centres within a 200km radius, including:

St. Michael’s Hospital
Mount Sinai Hospital
Credit Valley Hospital
Durham Regional Cancer Centre
St. Joseph’s Hospital
William Osler Health Centre
Trillium Health Centre
Royal Victoria Hospital
Grand River Regional Hospital
Sunnybrook Odette Cancer Centre
North York General Hospital
Southlake Regional Health Centre
Markham Stouffville Hospital
Toronto East General Hospital

Patients will be referred to COMPACT by their oncologists and come to The Princess Margaret for testing and to consent to the trial. A report (along with suggested treatment options) will be sent back to their primary physician to be reviewed with the patient. Treatment may take place elsewhere. This trial has just opened and 4 patients signed up to participate on the first day!

This will help us create a Personalized Cancer Medicine network that will benefit patients beyond The Princess Margaret!