Precision1 Trial May Allow for Precision Medicine in Liver Cancer by Integrating MRI With Whole Genome Sequencing

The prospective observational Precision1 cohort study will integrate imaging technology with actionable whole genome sequencing in patients with primary and secondary liver cancer.

Precision medicine may be achieved for patients with primary and secondary liver cancer by integrating quantitative magnetic resonance imaging with whole genome sequencing, a strategy that is currently being examined in the Precision1 study (NCT04597710), according to a press release from Perspectum.

This study will integrate Hepatica imaging technology with actionable whole genome sequencing and digital pathology to disrupt the cancer care pathway. Perspectum is partnering with genomic sequencing experts from the University of Oxford for the study.

“Precision1 will investigate how [artificial intelligence] may support clinical decision making, by integrating and scoring complex genetic, digital pathology and imaging data, in the management of liver metastases. This is a tremendously exciting blueprint for improving clinical decision making in the big data age,” Sarah Gooding, MD, a clinician scientist at the University of Oxford, said in a press release.

The Hepatica report helps to equip surgeons with the quantitative metrics necessary to evaluate a patient’s overall liver health prior to surgery. This will help surgeons determine if they want to modify the patient’s existing surgical plan.

Following surgical resection of the liver, Perspectum will collect and prepare the tumor tissue for whole genome sequencing. The data will be analyzed utilized the bioinformatics pipeline that was developed by the University of Oxford.

The study plans to enroll an estimated 200 participants and seeks assess how the integration of clinical, radiographic, and genomic data might help identify the most suitable treatment combinations for patients with liver cancer. Patients will be recruited from Hampshire Hospitals National Health Service (NHS) Foundation Trust or the Oxford University Hospitals NHS Foundation Trust.

The primary end point of the study is proportion of patients with clinically actionable data provided by genome sequencing at the time of surgery. Moreover, key secondary endpoints include proportion of patients with clinically actionable data provided by LiverMultiScan and correlation of digital pathology results with pathologist assessment of tumors. Correlation of magnetic resonance measurements of steatosis and fibroinflammation with digital pathology and human pathology, as well as ability of whole genome sequencing and LiverMultiScan to predict post-surgery duration of hospital stay, post-operative liver function, and 1-year mortality/recurrence are some of the other secondary end points.

In order to enroll, patients needed to be 18 years or older with the ability to give informed consent in addition to being considered for primary or secondary liver resection. Patients with any counterindication to MRI were not eligible to enroll. Other significant underlying diseases or disorders that may, in the investigator’s opinion, put the patient at risk were also not eligible to enroll in the study.

“This could represent another key step towards personalized care for patients with both primary and secondary cancer in the liver,” Myrddin Rees, OBE, consultant hepatobiliary surgeon at Hampshire Hospitals NHS Foundation Trust, concluded.

Reference:

New clinical study investigates using integrated diagnostics to enable precision medicine for liver cancer patients. News Release. July 9, 2021. Accessed August 17, 2021. https://bwnews.pr/3snxYkZ