Marathon of HopE Genome Sequencing to Inform Novel Treatments Portfolio Trial (MAESTRO)

A clinical trial to personalize cancer therapies for patients with advanced pancreatic cancer

With a five-year survival rate of only 10 per cent, pancreatic cancer is, unfortunately, one of the world’s deadliest cancers. Today, patients diagnosed with these cancers have very few treatment options, and those that exist are often ineffective.

To bring new hope to these patients, the Marathon of Hope Cancer Centres Network is investing in a clinical trial that will use next-generation sequencing to help match pancreatic cancer patients to personalized therapies, accelerating the implementation of precision medicine for patients with this deadly disease.

Partially funded through the Network’s pan-Canadian Projects program, the Marathon of HopE Genome Sequencing to Inform Novel Treatments Portfolio Trial (MAESTRO) brings together collaborators in Ontario, Quebec and British Columbia. We spoke to the three project leaders, Drs. Erica Tsang (Princess Margaret Cancer Centre), George Zogopoulos (Research Institute of the McGill University Health Centre) and Daniel Renouf (BC Cancer), to learn more about its potential for impact.

MOHCCN: It was recently announced that the Network would be funding the MAESTRO trial as part of its Pan-Canadian Projects program. What are the main objectives of this clinical trial?

Researchers: Our main goal is to offer pancreatic cancer patients targeted treatments that are tailored to the genetic changes in their tumours to improve outcomes and minimize side effects.

The main idea that guides our work is that patients with advanced pancreatic cancers may have genetic changes that we can target with new drugs or drug combinations. Funding from the Marathon of Hope Cancer Centres Network will allow patients to undergo detailed DNA and RNA testing to find these genetic changes. As part of MAESTRO, we will be able to match pancreatic cancer patients to specific drugs and new drug combinations that target these genetic changes. It will be run through the Canadian Cancer Trials Group (CCTG), meaning it will be accessible to patients across the country. 

Why is this important? How does it advance precision medicine for cancer? What potential impact could it have on patients?

Targeted treatments have been improving outcomes in other cancers like breast and ovarian cancer, but this is still not the case with pancreatic cancer, which has low survival rates. In this context, there is an urgent need to explore and develop targeted treatments for patients with pancreatic cancer to improve survival and quality of life.

With the rapid advances in genetic technologies, we are now able to identify some of the genetic changes that drive the development of pancreatic cancer and hopefully develop more targeted treatments. With limited standard of care treatment options in pancreatic cancer, it is incredibly important to consider clinical trials to be able to access cutting-edge new drugs, especially when these drugs are targeted to a patient’s specific genetic changes and may have a higher likelihood of working.

Why is it important for the Marathon of Hope Cancer Centres Network to fund this type of work?

The MOHCCN had the foresight to create a national network where Canadian patients would have access to state-of-the-art genome sequencing. The MAESTRO trial takes the sequencing information to the next step – offering patients new and targeted treatment options with the hope of improving survival and quality of life. As we learn more about the genetics of cancer, this type of trial represents the next generation of clinical trials where we can target and treat individual patients, rather than a one-size-fits-all approach.