Rationale

We are experiencing unprecedented advancements in the management of ovarian cancer due to the use of molecular medicine to guide cancer prevention and treatment. This has been made possible using sophisticated techniques to perform a variety of molecular analyses of cancer tissues. The collection of cancer tissue samples is therefore a crucial enabler for future advancements in ovarian cancer care. The genetic analysis of cancer tissues greatly improves our ability to screen patients for cancer mutations that run in families, and also allows us to better treat ovarian cancer patients with effective new drugs.

Purpose

The goal of this project is to establish a Tumour Testing and Ovarian Cancer Drug Prediction Program in Saskatchewan. This program will improve ovarian cancer outcomes in Saskatchewan through improved ovarian cancer prevention and treatment. The tumour testing program will then serve as an enabler to develop a novel research program in molecular drug prediction and will improve our ability to make evidence-based treatment decisions for patients. This program has the potential to affect not only patients with ovarian cancer, but all gynecologic cancers where biomarkers are being developed and linked with targeted therapies.

There are 3 specific issues that this program will address:

• Genetic testing of tumour samples is needed to prevent ovarian cancer in high-risk families;
• Improved patient access to PARP inhibitors;
• Personalizing treatment based on predicted benefit.

Embedded in this program is a patient-centred pragmatic (“real-world”) clinical trial led by Dr. Hopkins, “Patient Preferences for Precision Medicine; Determining Optimal Quality of Life using PARPi (4PDQ)”. This trial is now open for recruitment in Saskatoon. In this trial all women with high-grade serous ovarian cancer will have a special molecular test (called HRD testing) performed on their tumour sample. Patients whose tumours are found to be homologous recombination proficient (HRP) will be provided with a decision aid to help them decide whether to pursue treatment with a PARP inhibitor. This decision aid was co-developed with the Ovarian Cancer Canada Patient Partners in Research team.