Until recently, Quebec was the only province to cover the high cost of molecular testing for patients with biliary tract cancers.
They are rare cancers with few treatment options and low survival rates. But new molecular testing, available in Ottawa and across Canada, is offering patients some hope.
Every year about 800 Canadians are diagnosed with biliary tract cancers, which start in cells of the gallbladder or bile duct. Patients typically have late stage cancer by the time they are diagnosed.
There are drugs being used for other treatments that could potentially help patients with biliary tract cancers, but molecular testing is required to better understand which treatments and clinical trials are more likely to work for them, said Dr. Rebecca Auer, a surgical oncologist and senior scientist at the Ottawa Hospital and professor at the University of Ottawa.
Until recently, Quebec was the only province to cover the high cost of molecular testing for patients with biliary tract cancers. Patients in the rest of the country now also have free access to the testing, thanks to the Canadian Cholangiocarcinoma Collaborative (C3), a national research network that aims to change how patients with biliary tract cancer receive and access integrated research and care in Canada.
Auer is a co-founder of C3, which is based at the Ottawa Hospital. C3 was awarded a grant from the Canadian Cancer Society and the Canadian Institutes of Health Research, part of which goes toward molecular testing for patients outside of Quebec. The hope is that provinces and territories will eventually cover the cost of the testing.
The C3 network also offers expert advice to physicians who may be less familiar with the rare cancers to interpret the molecular tests and to make the best treatment decisions for their patients.
About 45 per cent of biliary tract cancers contain a mutation for which there is a drug available — for another form of cancer. That includes BRCA mutations. There are several drugs that target BRCA when it comes to breast and other cancers, she said.
Having that information could help a patient with biliary tract cancer get access to the drug or take part in a clinical trial.
There are drugs that could benefit biliary tract cancer patients that have been approved by Health Canada for other uses. Auer has proposed a program that gives Canadian patients with rare cancers a right to try drugs that could be beneficial. So far, that proposal has not been taken up.
She said the research funding to make molecular testing available is an important start to learning more about the rare cancers and potentially helping patients and their doctors find possible clinical trials or other ways to access potential therapies.
There is no guarantee, though, that getting a molecular test will ultimately help patients.
“Many oncologists will say having the opportunity to offer patients everything they can is important,” Auer said.
