TOPOGRAPH (Therapy-Oriented Precision Oncology Guidelines for Recommending Anti-cancer PHarmaceuticals) is an independent, oncologist-led effort of cataloguing literature and evidence to streamline the process of recommending drug treatments in precision cancer medicine.

This resource is intended to help oncologists find relevant literature when making treatment decisions for patients with advanced or metastatic cancer, using contemporary genomic profiling results and other assays.

TOPOGRAPH is a knowledgebase of predictive biomarkers in oncology and haematology, linking their therapeutic effects of anticancer drugs on the basis of published evidence. The types of biomarkers linked to therapies include but are not limited to:

• Gene biomarkers, including:
  • Simple mutations and variant groups
  • Copy number variations (amplification and deletions)
  • Fusions and rearrangements
  • Germline mutations
  • Combination biomarkers
  • Complex biomarkers
  • Splice variants
• Protein biomarkers by expression categories
• Selected methylations
• Selected genome-wide assays and/or metrics
• Selected predictive scores

Currently, TOPOGRAPH provides contents with reference to the Australian public health system. This resource is actively maintained as part of a nation-wide precision oncology program.

Most other publicly available KBs focus on delineating the significance of genomic alterations found through a diagnostic assay (e.g., comprehensive genomic profiling). In contrast, TOPOGRAPH addresses the real-world need of oncologists by focusing on the treatment selection aspects (hence "therapy-oriented").

TOPOGRAPH uses literature and evidence to understand the implications on a treatment (drug or drug combination) in the presence of a biomarker, identified by methods of molecular profiling and/or other assays (tests).

TOPOGRAPH is designed differently from other databases. To make this resource useful in clinics, TOPOGRAPH considers both accessibility (with respect to approval and reimbursement) and maturity of a drug (with respect to its stage of development, as well as the outcomes of relevant clinical trials) more closely. These aspects are important to consider when making rational clinical decisions about targeted cancer therapies.

More general discussions about the rationale behind this resource can be found here .

TOPOGRAPH adapts a grading/numbering system similar to OncoKB but defines a different set of literature criterias to align more closely with the needs of oncologists in practice (See Literature assessment criteria).

For access to genomic profiling options for Australian patients, please consider referral to:

• The Cancer Screening Program (CaSP) (provided by Omico Ltd.) and its Molecular Oncology Board.
• An accredited laboratory with clinical comprehensive genomic profiling services.
• Referral to dedicated research programs may be appropriate for certain patients.

• The Precision Care Clinic at Prince of Wales Hospital, Sydney, provides a service that partners with clinicians to navigate complex molecular findings through a formal MDT input after genomic profiling. The team combines expertise from medical oncology, clinical genetics and molecular pathology to enhance genomic result interpretation within each patient's unique clinical context. Face-to-face or telehealth reviews are available for patients when required. This service is part of a national health services research initiative, funded by Australia's Medical Research Future Fund (MRFF Rapid Applied Research Translational grant, RARUR000125), which aims to develop sustainable models in the Australian public health system for incorporating genomics into routine cancer care.

  To refer a patient, please use the online link: Referring clinicians - Precision Care Initiative | UNSW Sydney. There are no costs to patients or referring clinicians.

For information about cancer clinical trials, ARTICANZ - Annotated Registry of Trials in Cancer (Australia and New Zealand Ed) (Annotated Registry of Trials in Cancer, Australia/NZ Edition; ARTificial Intelligence-enhanced CANcer trial information database) is a free, open-information initiate designed to provide comprehensive categorisation of cancer drug trial information to oncologists/haematologists, researchers, trialists, patients, and different stakeholders in Australia and New Zealand.

POTTR is designed to integrate patient genomic testing results with TOPOGRAPH's knowledge base to produce evidence-based treatment recommendations. The system can:

• Rank potential therapies based on strength-of-evidence and level-of-recommendation, based on TOPOGRAPH
• Predict drug sensitivity and resistance by analyzing variant interactions
• Match patients to relevant clinical trials using local trial databases

When using data from TOPOGRAPH, please:

• State the database version accessed and date of access
• Acknowledge the appropriate licensing terms (see Licensing & Usage tab)
• If you modify or build upon TOPOGRAPH data, ensure your derivative work is also licensed under CC BY-SA 4.0