The AURORA Molecular Screening Programme for Metastatic Breast Cancer

An academia-driven initiative to boost genomic and clinical knowledge

AURORA is an academia-driven initiative that aims to boost genomic and clinical knowledge generated from metastatic breast cancer patients. It is expected that detailed molecular profiling of breast cancer makes deeper current understanding of the molecular biology underpinning this common disease, promising to lead to personalised cancer medicine, according to description of the programme goals and study plan in an article published by Dr Dimitrios Zardavas and colleagues in the British Journal of Cancer.

To date most research efforts have focused on the molecular analysis of the primary tumour to dissect the genotypes of the disease. However, accumulating evidence supports a molecular evolution of breast cancer during its life cycle, with metastatic lesions acquiring new molecular aberrations.

Recognising this critical gap of knowledge, the Breast International Group is launching AURORA, a large, multinational, collaborative metastatic breast cancer molecular screening programme.

AURORA is an effort dedicated to metastatic breast cancer that aims to interrogate the intratumour heterogeneity of the disease through the coupled genomic analyses of both primary tumour and metastatic lesions. 

Approximately 1300 patients with metastatic breast cancer who have received no more than one line of systemic treatment for advanced disease will, after giving informed consent, donate archived primary tumour tissue, as well as will donate tissue collected prospectively from the biopsy of metastatic lesions and blood. Both tumour tissue types, together with a blood sample, will then be subjected to next generation sequencing for a panel of cancer-related genes.

The patients will be treated at the discretion of their treating physicians per standard local practice, and they will be followed for clinical outcome for 10 years. Alternatively, depending on the molecular profiles found, patients will be directed to innovative clinical trials assessing molecularly targeted agents.

Samples of outlier patients considered as “exceptional responders” or as “rapid progressors” based on the clinical follow-up will be subjected to deeper molecular characterisation in order to identify new prognostic and predictive biomarkers.

The clinical development of promising targeted anticancer compounds is reshaping the design of future clinical trials. Indeed, genotype-driven clinical trials, bring a realistic assumption that targeted compounds will show overt activity against tumours bearing the targeted molecular aberrations.

In that regard, AURORA promises to boost the successful clinical development of targeted agents through its downstream clinical trials. Overall, the AURORA programme, through its innovative design, will shed light onto the unknown areas of metastatic breast cancer, bringing clinicians several steps closer to the implementation of precision medicine for their patients.

Acknowledgements

The project is supported by grants from the Breast Cancer Research Foundation, the Luxemburg Cancer Foundation, the Belgian Loterie Nationale, NIF Trust and BIG Against Breast Cancer. 

Reference

Zardavas D, Maetens M, Irrthum A, et al. The AURORA initiative for metastatic breast cancer. British Journal of Cancer (2014), Advance online publication 16 September. doi: 10.1038/bjc.2014.341