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Brief Title: The PIONEER Initiative: Precision Insights On N-of-1 Ex Vivo Effectiveness Research Based on Individual Tumor Ownership (Precision Oncology)

The PIONEER Initiative: Precision Insights On N-of-1 Effectiveness Research. Tissue Ownership by the Individual With the Return of Actionable Information to the Individual Patient and Physician (Precision Oncology)


  • Org Study ID: MYCT001
  • Secondary ID: N/A
  • NCT ID: NCT03896958
  • Sponsor: SpeciCare


The PIONEER Initiative stands for Precision Insights On N-of-1 Ex vivo Effectiveness
Research. The PIONEER Initiative is designed to provide access to functional precision
medicine to any cancer patient with any tumor at any medical facility. Tumor tissue is saved
at time of biopsy or surgery in multiple formats, including fresh and cryopreserved as a
living biospecimen. SpeciCare assists with access to clinical records in order to provide
information back to the patient and the patient's clinical care team. The biospecimen tumor
tissue is stored in a bio-storage facility and can be shipped anywhere the patient and the
clinical team require for further testing. Additionally, the cryopreservation of the
biospecimen allows for decisions about testing to be made at a later date. It also
facilitates participation in clinical trials. The ability to return research information from
this repository back to the patient is the primary end point of the study. The secondary end
point is the subjective assessment by the patient and his or her physician as to the
potential benefit that this additional information provides over standard of care. Overall
the goal of PIONEER is to enable best in class functional precision testing of a patient's
tumor tissue to help guide optimal therapy (to date this type of analysis includes organoid
drug screening approaches in addition to traditional genomic profiling).


The PIONEER Initiative is a lead clinical trial designed to provide the foundation for
subsequent adaptive trials. The mission with this and subsequent trial activity will be to
demonstrate the utility of carrying out functional precision medicine in that cohort of
patients who receive local cancer care at institutions that do not have significant research
capabilities or are not NCI-designated cancer centers. As discussed above, the vast majority
of cancer patients (~85%) are in this category. It is imperative to open up the possibility
of best-in-class functional precision medicine testing to these patients. Core aspects of the
PIONEER Initiative include recruiting a cadre of up to 200 patients, showing that proof of
concept in a more limited set of patients can ultimately scale to arbitrarily large numbers
of patients. It is anticipated that PIONEER will continue as the foundation for subsequent
clinical trials into the indefinite future. This evolving trial structure fills an important
unmet need within the broader cancer community since the primary mission is the return of
actionable information in order to positively impact care.

The underlying basic assumption of the PIONEER Initiative is that the ability to receive the
best in cancer care should not be restricted as to location, age, or medical condition. The
PIONEER Initiative design facilitates inclusion of subjects across all these divides, thus
providing beneficence to all participants. A key aspect of the PIONEER Initiative is to
provide patient benefit through a data and tissue biorepository to be utilized by researchers
to discover new cancer diagnostics, treatment therapies and preventive strategies.
Additionally, the data and samples will be used to improve existing treatments and to
understand, at the molecular level, changes occurring during transition from illness to
remission and/or relapse. SpeciCare, through the PIONEER Initiative, will store de-identified
self-reported data, medical records, and biological samples from individuals who consent to
participate in PIONEER. PIONEER will obtain further study and testing as appropriate and
return results, through CLIA certified labs, through research vetted by CLIA testing, and, as
enabled by current regulatory standards, through delivery of research results back to the
patient and patient's clinical care team.


1. To provide patient access to additional information about his or her tumor, including
functional precision cancer testing outside the patient's body, in order to provide
potential access to clinical trials, decreased toxicities, better outcomes, improved
overall care compared with the current standard, and potentially improved survival.

2. To establish a data and tissue biorepository comprised of high quality biological
specimens and associated clinical data that will support drug discovery, diagnostic
assay development, oncology biomarker discovery, molecular biology, immuno-oncology
therapies, translational medicine and other future discoveries as novel methods become

3. To facilitate and accelerate oncology research by providing a pipeline of high quality
specimens and associated clinical data for researchers to access.

  • Overall Status
  • Start Date
    March 21, 2019
  • Phase
  • Study Type


Primary Outcome 1 - Measure: Return of research information

Primary Outcome 1 - Timeframe: Two Years

Primary Outcome 2 - Measure: Assessment of benefit of return of research results

Primary Outcome 2 - Timeframe: Two Years

Primary Outcome 3 - Measure: Assessment of benefit of return of research results by SpeciCare Outcome Monitor Board

Primary Outcome 3 - Timeframe: Two Years


  • Cancer
  • All Types
  • Cancer of Liver
  • Cancer of Stomach
  • Cancer of Head and Neck
  • Cancer of Rectum
  • Cancer of Kidney
  • Cancer of Esophagus
  • Cancer of Colon
  • Cancer Skin
  • Cancer of Cervix
  • Cancer
  • Metastatic
  • Cancer of Larynx
  • Cancer of Neck
  • Cancer of Lung
  • Cancer of Brain and Nervous System
  • Cancer of Vulva
  • Disseminated
  • Cancer of Pancreas
  • Sarcoma
  • GIST
  • Small-cell Lung Cancer
  • Adenocarcinoma Lung
  • Cancer of Prostate
  • Cancer
  • Advanced
  • Adrenal Cancer
  • Testicular Cancer
  • Uterine Cancer
  • Bronchoalveolar Cell Lung Cancer
  • Cancer Unknown Primary
  • Glioblastoma Multiforme
  • Oligodendroglioma
  • Breast Cancer
  • Renal Cell Carcinoma
  • Hepatocellular Carcinoma
  • Cholangiocarcinoma
  • Squamous Cell Carcinoma
  • Transitional Cell Carcinoma
  • Cancer
  • Other
  • Cancer
  • Anal
  • Melanoma
  • Cancer
  • Bile Duct
  • Cancer
  • Bladder
  • Cancer Cords Vocal
  • Cancers Cell Neuroendocrine
  • Cancer Differentiated Poorly
  • Cancer
  • Anaplastic Thyroid


Inclusion Criteria:

- All patients diagnosed with cancer and all patients at risk of cancer

Exclusion Criteria:

-Patients who decline definitive therapies Patients with comorbidities that prevent
definitive therapies Patients on hospice

Gender: All

Minimum Age: 99 Years

Maximum Age: 1 Month

Healthy Volunteers: No


Name: Fredrik Vannberg, DPhil

Role: Study Chair

Affiliation: SpeciCare

Overall Contact

Name: Fredrik Vannberg, DPhil

Phone: 7708618747



Facility Status Contact
Facility: Specicare
Gainesville, Georgia 30501
United States
Status: Recruiting Contact: Ken Dixon, MD