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Advancing plasma whole genome sequencing to better treat and monitor patients with pancreatic and biliary cancers

Pancreatic and biliary cancers are some of the most challenging to treat using precision medicine approaches, in part due to the difficulty in obtaining sufficient tissue for genetic testing, which is crucial for identifying therapeutic targets. 

To close this gap and advance precision for these cancers, a new pan-Canadian team led by Dr. Erica Tsang at the University Health Network and funded by the TFRI-MOHCCN Technology Development Award, will explore an innovative solution: plasma whole genome sequencing. This advanced technology has the potential to transform how these cancers are detected and monitored, offering new hope for patients. 

"There is an urgent need to develop more effective treatments for pancreatic and biliary cancer patients," explains Dr. Tsang. "The anatomy of these cancers makes it difficult to obtain enough tissue for traditional biopsies. That's where plasma whole genome sequencing comes in." 

Unlike conventional methods that rely on tissue biopsies, plasma whole genome sequencing uses a non-invasive blood draw to detect and track circulating tumour DNA (ctDNA). This makes it possible to easily collect and analyze samples at different time-points of a patient’s disease. 

“Our goal is to collect serial blood draws for ctDNA as part of existing Marathon of Hope Cancer Centres Network cohorts for patients with advanced pancreatic and biliary cancers,” says Dr. Tsang. "By comparing these genetic changes with those found in tumour tissue, we hope to better understand how to incorporate ctDNA into the routine care of these patients." 

Collecting blood samples from patients throughout the evolution of their disease and analyzing them using this cutting-edge technology will allow the team to search for genetic changes driving cancer development at different stages. This increases the potential for impact of this project: by tracking changes in ctDNA levels over time, researchers can identify new mutations that may signal resistance to current treatments, leading to earlier interventions and more personalized treatment plans, improving outcomes for patients with these aggressive cancers. 

By supporting this project, the TFRI-MOHCCN Technology Development Award is investing in developing and refining a technology that can potentially be applied across Canada, paving the way for more effective, less invasive cancer treatments that can be applied in real time to inform clinical decisions throughout the country. 

"Through this project, we really want to show that we can increase the use of non-invasive blood draws to better monitor disease trajectory and identify genetic changes that will help us match patients to the appropriate targeted therapies," adds Dr. Tsang. "Ultimately, we hope that this approach will help us make more informed decisions and improve the lives of our patients."