We welcome collaboration with other researchers in both academia and industry.

SMMART stands for Serial Measurements of Molecular and Architectural Responses to Therapy. It is the flagship project of the Knight Cancer Institute’s precision oncology program.

Our goal is to identify new treatments that last longer and improve the quality of life for patients with advanced cancer.

We perform comprehensive tumor analytics on every patient before, during and after treatment to look for clues as the tumor evolves. This includes:

• Informing treatment in real time using our clinical analytics platform (SMMART-CAP).
• Learning more about resistance mechanisms and investigating novel biomarkers using our exploratory research analytics platform (SMMART-ERA).

Are you a patient? Find more information at SMMART for patients.

SMMART clinical trials

Here’s a list of SMMART clinical trials we are conducting or expect to open soon.

MMTERT

• Title: Tumor Evolution and Resistance in Response to Therapy
• Goal: To identify methods and tests that can help us deliver better cancer treatment. This study will help us learn:
  • The best ways to get cancer samples from patients.
  • Which tests provide the most useful insight about a patient’s cancer.
  • The best way to relay this information to the doctor.
• Disease: Localized, advanced or metastatic cancer
• Investigator: Gordon Mills, M.D., Ph.D.
• More information: OHSU IRB# 16113

SMMART-PRIME

• Title: Precision Medicine Approach to Identify Novel Combination Therapies for Advanced Cancers
• Goals:
  • To see if testing a patient’s tumors can help us find specific drug combinations to treat them.
  • To understand why some people respond to a certain therapy and other people do not.
  • To learn why anti-cancer drugs often stop working.
• Disease: Metastatic cancer and advanced cancer
• Investigator: Lara Davis, M.D.
• More information: NCT03878524

SMMART-ACT

• Title: Adaptive Clinical Treatment Trial
• Goal: To identify unique drug combinations tailored to each patient and their tumor, over time. The drugs in this study are known to be effective for one type of cancer, but we may combine them with other drugs to treat a different type of cancer.
• Disease: Advanced breast, pancreas, prostate and ovarian cancers or sarcomas
• Investigator: Lara Davis, M.D.
• More information: NCT05238831

AMTEC

• Title: Adaptive Multi-drug Treatment of Evolving Cancers
• Goal: To see if combining olaparib with durvalumab, selumetinib, capivasertib or ceralasertib provides more benefit to patients than standard therapy.
• Disease: Metastatic triple-negative breast cancer (TNBC)
• Investigator: Evie Hobbs, M.D.
• More information: NCT03801369

WOO

• Title: Window of Opportunity Trial for Patients With Pancreatic Cancer
• Goal: To see if cobimetinib, olaparib, temuterkib or onvansertib work better than standard therapy.
• Disease: Locally advanced or metastatic adenocarcinoma of the pancreas
• Investigator: Charles Lopez, M.D., Ph.D.
• More information: NCT04005690

PANNTHR

• Title: Abemaciclib and Niraparib Before Surgery for the Treatment of Hormone Receptor Positive HER2 Negative Breast Cancer
• Goal: To test the side effects and best dose of abemaciclib and niraparib in patients with breast cancer that is hormone receptor-positive and HER2 negative. Giving abemaciclib and niraparib together before surgery may make the tumor smaller.
• Disease: Breast cancer that is HR+ and HER2-
• Investigator: Evie Hobbs, M.D.
• More information: NCT04481113

Major OHSU collaborators

• Knight Diagnostic Laboratories
• Immune Monitoring and Cancer Omics Laboratory
• OHSU Knight Cancer Institute BioLibrary
• OHSU Histopathology Shared Resource
• Human Tumor Atlas Network
• Brenden-Colson Center for Pancreatic Care
• Coussens Lab
• Heiser Lab
• Mills Lab

Selected publications

1. An Omic and Multidimensional Spatial Atlas from Serial Biopsies of an Evolving Metastatic Breast Cancer.
   Cell Reports Medicine, Feb. 15, 2022
   This paper highlights one patient’s journey through the SMMART program, detailing the novel toolbox of tests and research used to better understand how tumors change in response to treatment.
2. Multiomics Analysis of Serial PARP Inhibitor Treated Metastatic TNBC Inform on Rational Combination Therapies.
   NPJ Precision Oncology, Oct. 19, 2021
   This pilot study presents the benefit of the SMMART platform to help identify patients who may benefit from novel combination therapies by evaluating tumor responses while a patient is still on therapy.
3. Characterizing Advanced Breast Cancer Heterogeneity and Treatment Resistance Through Serial Biopsies and Comprehensive Analytics.
   NPJ Precision Oncology, March 26, 2021
   This paper explores the urgent need to identify how to best treat a cancer patient with diverse tumor biology. It highlights SMMART’s approach to comprehensively follow a patient over time.
4. Exceptional Response to Trastuzumab in a Heavily Pretreated Patient With ERBB3-Mutated Metastatic Breast Cancer.
   JCO Precision Oncology, Jan. 8, 2021
   This case study showcases a patient with advanced breast cancer whose treatment options were exhausted. Enrollment in SMMART provided the opportunity to thoroughly analyze the tumor using the SMMART Analytics Platform and successfully recommend an innovative therapeutic option.
5. Implementing a Comprehensive Translational Oncology Platform: From Molecular Testing to Actionability.
   Journal of Translational Medicine, Jan. 8, 2021
   This paper describes the feasibility of establishing a successful precision oncology program to benefit patients at the Knight Cancer Institute.