Everything You Need to Know About POG (Personalized OncoGenomics Program)

POG is the cancer trial featured in the Nature of Things doc, Cracking Cancer.

What is POG exactly?

POG (Personalized OncoGenomics) compares the patient’s normal DNA (each cell’s complete set of instructions) with the DNA of their tumours. It also compares the RNA of their tumours to reference RNA. By doing these comparisons, POG is searching for a mutation or other sorts of abnormalities that might be implicated in causing that person’s cancer to grow and spread. If they can isolate abnormalities that are driving the cancer, then they can search for a drug that might block the cancer’s growth; although sometimes even when they identify what is driving the cancer, it is not possible to block that pathway. 

SCENE FROM THE FILM: Behind the scenes at the BC Cancer Agency.
What makes POG different from other cancer treatments?

POG is a radical way of treating cancers — not according to where they originate in the body, but rather as a disease of genetic mutations. Generally, cancer treatments are chosen based on what has been previously given to other people with the same type of cancer. Although this works for some people’s cancers, it doesn’t work for everyone. POG is about trying to customize a treatment for each individual person’s cancer, or what is known as “personalized medicine”. 

POG has clearly demonstrated that cancer is immensely complex and each person’s cancer is unique; this makes the identification of possible drug targets a difficult process. 

How does POG help other cancer patients?

The team has built a genomic platform that takes patients with all types of cancers from consent to biopsy to in-depth genomic analysis; this does not exist anywhere else in the world. The program enables the team to study advanced cancers in a new way and with unprecedented detail. By sharing their data with researchers around the world, everyone gains a better understanding of how cancer grows and how to fight this disease. 

When was POG started?

When POG launched in 2012, there were only 30 cancer patients in the trial. Initial results were so promising that, two years later, they expanded to take in 300 people with incurable cancer. By the end of 2016, they had enrolled 750 people. They’re aiming for 5,000.

How long does it take for a POG analysis? 
The Facts on Cancer
- Cancer is responsible for 30 per cent of deaths in Canada
- 2 in 5 people develop cancer during their lifetimes
- 1 in 4 people will die from cancer.
- New cancers are expected to increase 40 per cent over the next 15 years

The POG process takes about three months, from biopsy to completion of genome analysis. This may seem like a very long time to wait, but the complexity and care that goes into the analysis of a person’s cancer genome requires a lot of sophisticated computer work, and time for highly-skilled genome analysts to research the findings for each individual. 

How much does it cost?

In the past five years, the price tag for individual genome sequencing has come down from $250,000 to about $20,000. Some of this cost is dropping because the technology is becoming less expensive, but the worker-hours time involved in the analysis is not likely to decrease as dramatically. 

Who can enroll?

Currently only British Columbia residents can enrol in the trial, but POG is branching out to national and international collaborations soon.

Can POG be used for other diseases?

POG can potentially be used for other cancer-like diseases that also involve tumour growth.

Where can I find out more?

Patients must be referred to POG by their medical oncologist. Visit the BC Cancer Agency.

Available on CBC Gem

Cracking Cancer

Nature of Things