SMMART Program: A multi-omics tumour board with a focus on breast cancer
Dr Ben Kong - Oregon Health & Science University, Portland, USA
The SMMART Program is our precision oncology platform. We are utilising the platform to help learn about tumour biology and how it evolves over time. With each iteration we hope to identify targets that we can target for the tumour to gain some effect.
Why is the SMMART Program needed?
The program is needed because of how cancer is a very heterogeneous disease, not only is it different from person to person but it’s also different in the person’s body as it changes over time. So the reason why the program is needed is to help interrogate what those differences are in order to best optimise treatment.
How does it work?
The way the program works is that we have a patient who is interested in it and gets enrolled into the program. From there we obtain a small tissue sample of the cancer and that will serve as a baseline. From that tissue sample we run a multitude of analytics to help identify the different layers of biology that we are interested in. Once we have all that information available we go through a tumour board that has a lot of specialists there to help review the data, provide input on what therapy we can suggest. Once we have the patient receive that therapy we do longitudinal monitoring over time to really understand how that tumour responds. If we do see signs of progression the patient is invited to come back and we can do another biopsy to again understand what are some of the reasons for the tumour not responding to the therapy and, more importantly, can we find another way of finding some of its weaknesses.
What are the results so far?
Right now we have some preliminary results that are looking at a couple of areas. One, because the program is interested in tumour biology over time, we have been able to realise that some of the receptors are changing in response to therapy. So tumour heterogeneity as it evolved over time is one aspect of the program that we are finding out. The other part that’s also very exciting is we are starting to see signals that we are getting clinical benefit for patients that receive a matched therapy. There is going to be more analysis to come but we’re excited to really show that the program has some value in finding out molecular weaknesses that are available for current treatment to help target it.
How might this benefit breast cancer patients and physicians?
The way that we would have been helping our patients so far is, one, cancer is a very complex disease and very different. So the way we’re able to help our clinicians right now is by helping our clinicians figure out what are some unique treatments that we can identify that could be beneficial, something that might not have been picked up through standard of care. From the tumour board providing input and insight on various treatments, we give options for that treating physician.
Secondly, not only do we want to help provide recommendations, we also work alongside our provider to see if we can help obtain the drug so that they can actually utilise it for their patient.