Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

How can digital health be used to improve outcomes in pancreatic ductal adenocarcinoma (PDAC)? Examining the potential of the PURPLE Translational Pancreatic Cancer Platform (#52)

Belinda Lee 1 2 3 4 , Julia Shapiro 3 5 , Benjamin Thomson 1 6 7 , Sumitra Ananda 1 7 8 , Lara Lipton 1 5 7 , Sue-Anne McLachlan 9 , Rachel Wong 10 11 , Prasad Cooray 12 , Matthew Burge 13 , Kate Clarke 14 , Sharon Pattison 15 16 , Mehrdad Nikfarjam 6 17 , Niall Tebbutt 17 , Marion Harris 18 , Daniel Croagh 18 , David Goldstein 19 , Adnan Nagrial 20 , Rob Zielinski 21 22 23 , Amitesh Roy 24 , Cheng Ean Chee 25 , Tracy Putoczki 2 , Frederic Hollande 26 27 , Oliver Hofmann 26 27 , Joep Vissers 27 , Sean Grimmond 26 27 , Peter Gibbs 2 7 8 28
  1. Peter MacCallum Cancer Centre, Parkville, VIC, Australia
  2. Walter and Eliza Hall Institute, Melbourne, VIC, Australia
  3. Faculty of Medicine & Health Sciences, Monash University, Melbourne, Australia
  4. Northern Health, Epping, VIC, Australia
  5. Cabrini Hospital, Malvern, VIC, Australia
  6. Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
  7. The Royal Melbourne Hospital, Parkville, Melbourne, VIC, Australia
  8. Western Health, Melbourne, VIC, Australia
  9. St Vincents Hospital, Melbourne, VIC, Australia
  10. Eastern Health, Boxhill, VIC, Australia
  11. Epworth Hospital, Boxhill, VIC, Australia
  12. Knox Private Hospital, Knox, VIC, Australia
  13. Royal Brisbane Hospital, Brisbane, QLD, Australia
  14. Wellington Hospital, Capital & Coast District Health, Wellington, New Zealand
  15. Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
  16. Dunedin Hospital, Southern District Health, Dunedin, New Zealand
  17. Austin Health, Melbourne, Victoria, Australia
  18. Monash Cancer Centre, Melbourne, VIC, Australia
  19. Prince of Wales Hospital, Sydney, NSW, Australia
  20. Crown Princess Mary Centre, Westmead, NSW, Australia
  21. Orange Hospital, Orange, NSW, Australia
  22. Dubbo Base Hospital, Dubbo, NSW, Australia
  23. Bathurst Base Hospital, Bathurst, NSW, Australia
  24. Flinders Medical Centre, Bedford Park, SA, Australia
  25. National University Cancer Institute, Singapore
  26. Department of Clinical Pathology, University of Melbourne, Parkville, VIC, Australia
  27. The University of Melbourne Centre for Cancer Research, Parkville, VIC, Australia
  28. Faculty of Medicine & Health Sciences, University of Melbourne, Melbourne, VIC, Australia

Background: The PURPLE Translational registry supports analysis of large amounts of structured clinical and molecular data from routine clinical practice, into a single collaborative data repository. We explored whether, by utilising digital health technology, we could potentially enable big data insights into PDAC.

 

Methods: The PURPLE Translational Pancreatic Cancer registry is a collaborative effort among 27 institutes. Employing an electronic web-based platform for entry of key clinicopathological and outcome data on consecutive patients with PDAC. This federated platform allows de-identified data to be combined and analysed for research purposes, whilst maintaining privacy, confidentiality and data security, with the goal of supporting clinical, genomic, and translational research. 

 

Results: Between January 2016 and June 2019, 1279 PDAC patients with >400 matched biospecimens, 369 resections and 486 biopsy specimens have been entered in PURPLE. Median age at diagnosis was 69 (range 20-94 years), and 681/1279 (53%) were male. Overall 754/1279 (59%) patients presented with localised disease; 350/1279 (27%) were deemed resectable, 148/1279(12%) borderline resectable, and 247/1279 (20%) unresectable. A further 445/1279 (35%) were metastatic and 80 (6%) were not fully staged. Targeted molecular sequencing performed in 143 PDAC patients identified mutations in KRAS in 131 (92%), BRAF in 1 (1%), TP53 in 72 (71%), CDKN2A in 41 (41%), and PIK3CA in 2 (2%). BRCA/ BRCA-like signatures were identified in 5 of 75 cases undergoing Genome Sequencing (WGS). Since September 2019, 20 WGS cases were reviewed by the Molecular Tumour Board and Precision Oncology Program at the Victorian Comprehensive Cancer Centre. Research in circulating tumour DNA, biomarkers, and organoid models is also being supported by the PURPLE translational pancreatic cancer platform.

 

Conclusion: The comprehensive data collected in the PURPLE registry supports a broad range of research focused on precision oncology, including linking molecular data that can help identify candidates for targeted interventions.