August 28, 2020

Tumour traces in blood could predict which cancer patients will benefit from immunotherapy

OICR-supported researchers and collaborators discover indicators in the blood that may predict which patients will respond to the immunotherapy drug, pembrolizumab

Dr. Scott Bratman, Cindy Yang, Dr. Lillian Siu, Dr. Trevor Pugh

Adapted from UHN’s Media Release.

Immunotherapy can shrink tumours and prolong survival for certain cancer patients, but clinicians don’t yet know which patients will benefit from these treatments. OICR-supported researchers and collaborators at the Princess Margaret Cancer Centre have made a discovery that could help identify those patients who may benefit and match them with potentially life-saving therapies.

In their study, recently published in Nature Cancer, the research group found that the changing levels of tumour fragments, or circulating tumour DNA (ctDNA), in a patient’s blood can be used to predict whether they will respond to the immunotherapy drug pembrolizumab.

The study lays the foundation for researchers to develop an easy, non-invasive and quick blood test to determine who will benefit from the drug and how well their disease is responding to treatment.

“While we have known for some time that cancer disease burden can be monitored by measuring tumour DNA in the blood, we are excited to report that the same concept can be applied to track the progress of patients being treated with pembrolizumab,” says co-first author Cindy Yang, PhD Candidate in Dr. Trevor Pugh’s lab at the Princess Margaret Cancer Centre and OICR. “This will hopefully provide a new tool to more accurately detect response and progression in patients undergoing immune checkpoint inhibitor therapy. By detecting progression early, patients may have the opportunity to undergo subsequent lines of treatment in a timely fashion.”

The benefits of blood tests

Conventionally, imaging scans – such as computerized tomography (CT) scans – and other methods are used to monitor a patient’s cancer. This study suggests a simple and quicker blood test as an alternative to these scans.

“Although important, computerized tomography (CT) and other scans alone will not tell us what we need to know quickly or accurately enough,” says senior author Dr. Lillian Siu, Senior Scientist and medical oncologist at the Princess Margaret Cancer Centre.

Dr. Scott Bratman, radiation oncologist and Senior Scientist at the Princess Margaret Cancer Centre and co-first author of the study, points out that it may take many months to detect whether a tumour is shrinking with various imaging scans. 

“New next-generation sequencing technologies can detect and measure these tiny bits of cellular debris floating in the blood stream accurately and sensitively, allowing us to pinpoint quite quickly whether the cancer is active.”

This study represents one of the many emerging applications of using ctDNA to guide treatment decisions. It is one of the first to show that measuring ctDNA could be useful as a predictor of who responds well to immunotherapy across a broad spectrum of cancer types. 

The prospective study analyzed the change in ctDNA from 74 patients, with different types of advanced cancers, being treated with pembrolizumab. Of the 74 patients, 33 had a decrease in ctDNA levels from their original baseline levels to week six to seven after treatment with the drug. These patients had better treatment responses and longer survival. Even more striking was that all 12 patients who had clearance of the ctDNA to undetectable levels during treatment were still alive at a median follow-up of 25 months.   

Conversely, a rise in ctDNA levels was linked to a rapid disease progression in most patients, and poorer survival.   

“Few studies have used a clinical biomarker across different types of cancers,” says Siu, who also co-leads OICR’s OCTANE trial. “The observation that ctDNA clearance during treatment and its link to long-term survival is novel and provocative, suggesting that this biological marker can have broad clinical impact.” 

Innovation and translation

This study is part of a larger flagship clinical trial, INSPIRE, which has enrolled more than 100 patients with head and neck, breast, ovarian, melanoma and other advanced solid tumours. INSPIRE brings together researchers from many disciplines to investigate the specific genomic and immune biomarkers in patients that may predict how patients will respond to pembrolizumab.

INSPIRE is made possible by collaborations across institutes and industries with expertise from those applying genomics to research and those applying genomics in the clinic.

“INSPIRE is an incredibly collaborative initiative that is a blend of big genomics – looking at large trends across many individuals – and highly-personalized genomics – looking at mutations within each patient sample,” says Pugh, co-senior author, Senior Scientist at Princess Margaret and Senior Investigator and Director of Genomics at OICR. “This is a modern approach to the translation of clinical genomics.”

“As a PhD student, this project gave me the unique opportunity to work in a highly collaborative intersection with industry, clinical, and academic partners,” says Yang. “It is very exciting to see translational research in action.”

Read the UHN Media Release.

August 28, 2020

The tools behind the treatment: Building image-guided devices for more accurate and effective cancer procedures

OICR-supported researchers develop multi-purpose AI algorithm to help track needle placement and improve the accuracy of several image-guided treatment techniques

Dr. Derek Gillies and Jessica Rogers
Dr. Derek Gillies and Jessica Rodgers

Cancer patients often encounter many needles, some of which are used to collect tissue samples or deliver therapy directly to a tumour. Specialists who carry out these procedures are trained to place needles precisely in the correct location, but what if we could give these specialists a real-time GPS for needles? Would biopsies be more accurate? Could needle-related therapies be more effective?

Dr. Aaron Fenster’s lab is working to develop tools for these specialists to guide their needles and ultimately improve the accuracy of biopsies and therapies for patients. In their recent paper, published in Medical Physics, they describe their new deep learning method to track needles in ultrasound images in real time.

“It may be surprising to many individuals, but a lot of these procedures are still done based on skill alone and without image processing,” says Dr. Derek Gillies, medical physicist in training and co-first author of the paper. “We’re working to provide clinicians with tools so they can better see their needles in real time rather than going in blind for some procedures.”

The deep learning methods presented in this paper are applicable to many types of needle procedures, from biopsies – where a clinician draws a tumour sample from the body – to brachytherapy – where a clinician delivers radiotherapy directly to the tumour. The methods could also be applied to several cancer types including kidney cancer, liver cancer and gynecologic cancers.

“Developing artificial intelligence algorithms requires a lot of data,” says Jessica Rodgers, co-first author of the paper and PhD Candidate at Western University’s Robarts Research Institute. “We didn’t have a lot of imaging data from gynecologic procedures, so we decided to team up to develop a method that could work across several applications and areas of the body.”

“That’s the most exciting aspect of this effort,” says Gillies. “To our knowledge, we were the first to develop a generalizable needle segmentation deep learning method.”

Now, members of the Fenster lab are working to integrate these algorithms into the video software equipment used in the clinic.

“Our work is giving clinicians new tools, which can help them make these procedures more precise and more accessible,” says Rodgers. “These tools could ultimately help lead to fewer missed cancer diagnoses and fewer patients with cancer recurrence.”

Read more about OICR’s Imaging Program, or the latest OICR Imaging news.

August 25, 2020

New advances towards targeted therapies for triple negative breast cancer

OICR-supported researchers demonstrate new drug may eliminate triple negative breast cancer cells in certain patients, discover a new method to identify which patients will benefit

Dr. Mathieu Lupien
Dr. Mathieu Lupien (Images by Delmar)

Adapted from UHN’s Media Release.

Triple negative breast cancer (TNBC) is a highly aggressive subtype of breast cancer that often spreads to other organs and accounts for one in four breast cancer deaths. OICR-supported researchers at the University Health Network’s Princess Margaret Cancer Centre are zeroing in on the molecular mechanisms that fuel this deadly cancer’s runaway growth to develop more effective treatments for this disease.

In their study, recently published in Nature Communications, they found a promising approach that could potentially identify the patients who could benefit from a more precise, targeted therapy for TNBC.

“This disease has no precision medicine, so patients are treated with chemotherapy because we don’t have a defined therapeutic target,” says co-lead of the study Dr. Mathieu Lupien, Senior Scientist at the Princess Margaret Cancer Centre and OICR Investigator. “Initially, it works for some patients, but close to a quarter of patients recur within five years from diagnosis, and many develop chemotherapy-resistant tumours.”

“These savage statistics mean that we must improve our understanding of the molecular basis for this cancer’s development to discover effective, precise targets for drugs, and a companion test to identify which patients are most likely to benefit the most from such a therapy.”

The study investigated how TNBC cells are dependent on a specific protein called GLUT1 and its associated molecular pathways. Prior studies suggested that TNBC cells were dependent on GLUT1, but this study is the first to demonstrate that blocking GLUT1 function may be an effective therapeutic strategy for certain patients with TNBC.

Using a collection of cell lines, the researchers found that blocking this pathway with a drug-like chemical compound “starved” the cancer cells, but only in a subset of TNBC patient samples. The group investigated further and found a common trait between the cell lines that were sensitive to the drug – they had high levels of a protein called RB1. This indicates that patients with TNBC and high levels of RB1 may, one day, benefit from this drug.

“Having access to diverse cell models of triple-negative breast cancer allows us to distinguish where the potential drug will work, and where it won’t,” says Lupien. “Without this broad spectrum of samples, we might have missed the subset of triple-negative breast cancers that respond to our compound.”

Dr. Cheryl Arrowsmith
Dr. Cheryl Arrowsmith (Photo credit: The Princess Margaret Cancer Foundation)

Collectively, this study suggests that clinical evaluation of targeting GLUT1 in certain patients with TNBC is warranted.

“The more we understand about the molecular complexity of cancer cells, the more we can target with precision,” says co-lead of the study Dr. Cheryl Arrowsmith, Chief Scientist for the Structural Genomics Consortium Toronto laboratories and Professor of Medical Biophysics at the University of Toronto. “And the more we can build up a pharmacy of cancer drugs matched to specific changes in the cancer cell, the greater the chance of a cure.”

Read UHN’s Media Release.

July 29, 2020

Q&A with new OICR investigator Dr. Courtney Jones on benefitting patients through research

OICR welcomes Dr. Courtney Jones to Ontario’s cancer research community

Courtney Jones

Starting up an independent research lab in the midst of a pandemic is difficult but Dr. Courtney Jones is up for the challenge. Jones moved to Canada prior to the lockdown and has been gearing up for new experiments since. Now, as an OICR Investigator, she has safely started working in her lab at the Princess Margaret Cancer Centre to find new solutions for the leading cause of leukemia deaths in Canada – acute myeloid leukemia (AML).

Continue reading – Q&A with new OICR investigator Dr. Courtney Jones on benefitting patients through research

July 27, 2020

Evolving treatment to evolving tumours: How OICR-supported researchers are getting ahead of ovarian cancer

OICR-supported Phase II trial uncovers how ovarian cancers become resistant to treatment, identifies new opportunities to personalize treatment for future patients

Clinician investigator Dr. Stephanie Lheureux has seen many women fight ovarian cancer – some who overcome the disease and unfortunately many who die. These women inspire Lheureux to find new effective treatments and to continue improving how we treat the disease.

One remarkable patient inspired the EVOLVE trial. After years of keeping her ovarian cancer in check, her cancer began to grow again, indicating that it had become resistant to the maintenance treatment she was on. Lheureux presented the option of palliative chemotherapy, as the latest guidelines suggest, but her patient declined – she wanted a different treatment that would allow her to have a healthy life outside of the hospital.

Dr. Stephanie Lheureux

“This type of chemotherapy requires several visits to the hospital and it’s associated with side effects on patients’ hair, skin and nails,” says Lheureux, Clinician Investigator at the University Health Network’s Princess Margaret Cancer Centre. “This patient didn’t want to go on standard chemotherapy. She had participated in several clinical trials before, and she urged me to find her another option.”

Continue reading – Evolving treatment to evolving tumours: How OICR-supported researchers are getting ahead of ovarian cancer

July 24, 2020

OICR research leads to new pancreatic cancer clinical trial with aim to change the standard of care for patients

New pancreatic cancer trial, NeoPancONE, launches across Canada

NeoPancONE

Adapted from Pancreatic Cancer Canada’s press release.

OICR’s PanCuRx team and collaborators have launched NeoPancONE, a Phase II clinical trial that will evaluate a potentially curative treatment strategy for operable pancreatic cancer. The trial, which is supported by Pancreatic Cancer Canada, will recruit patients at 10 cancer centres across the country to evaluate the effectiveness and feasibility of peri-operative chemotherapy – chemo treatment before and after surgery.

Typically, only 50 per cent of pancreatic cancer patients receive chemotherapy after surgery due to a range of personal and health reasons. NeoPancONE will help evaluate whether chemotherapy treatment before surgery can help extend the lives of these individuals.

Continue reading – OICR research leads to new pancreatic cancer clinical trial with aim to change the standard of care for patients

July 23, 2020

Prevention before treatment: How an OICR investigator is shifting the paradigm of chronic disease in Canada

The BETTER Program for chronic disease prevention and screening now customized for young adults, women and cancer survivors across the country

Dr. Eva Grunfeld

Cancer doctors are extensively trained to find and treat the disease, but what about preventing cancer in the first place?

Dr. Eva Grunfeld is dedicated to making prevention a priority.

In 2012, Grunfeld established the BETTER Program and today, this Canada-wide initiative is expanding and adapting to serve more individuals across the country.

Since its inception, BETTER has trained nearly 250 health professionals to become Prevention Practitioners who specialize in chronic disease prevention and screening. These Prevention Practitioners work in the primary care setting to develop personalized “prevention prescriptions” that are tailored to each patient based on an in-depth analysis of their medical history, family history, lifestyle factors, and other risk factors for diabetes, cardiovascular disease and cancer.

Continue reading – Prevention before treatment: How an OICR investigator is shifting the paradigm of chronic disease in Canada

July 21, 2020

OICR Drug Discovery awarded for COVID-19 research

OICR researchers and collaborators awarded $520,000 in new funding for COVID-19 drug discovery project

Dr. Gennady Poda
Dr. Gennady Poda, OICR Scientific Advisor and Group Leader

OICR Scientific Advisor and Group Leader, Dr. Gennady Poda, and collaborators at Sunnybrook Research Institute have been awarded $520,000 to identify new therapeutics and existing drugs that could be repurposed for the treatment of COVID-19. This award, which was announced on July 17 by Premier Doug Ford, is part of the Government of Ontario’s $20 million COVID-19 Rapid Research Fund.

Using OICR supercomputers and advanced computational chemistry techniques, Poda and collaborators aim to identify drugs that can stop the virus from replicating in the body by targeting the virus’ key polymerase enzyme, RdRP.

“We’ll be looking for new potential drugs to treat the COVID-19 infections by rapidly identifying approved drugs and compounds that are in clinical trials that could inhibit RdRP,” says Poda. “We will advance the most promising compounds into preclinical animal models and, if the data is promising, into patients.”

Continue reading – OICR Drug Discovery awarded for COVID-19 research

July 8, 2020

Protecting cancer patients from COVID-19: world-first clinical trial tests a novel immune-boosting strategy

Dr. Rebecca Auer with colleague. Credit: The Ottawa Hospital

In the race to find new ways to prevent and treat COVID-19, OICR-supported researchers have launched an innovative clinical trial focussed on strengthening the immune system for one of the most vulnerable populations – cancer patients.

The trial involves IMM-101, a preparation of safe, heat-killed bacteria that broadly stimulates the innate, or “first-response,” arm of the immune system. The researchers hope that boosting cancer patients’ immune systems with IMM-101 will protect them from developing severe COVID-19 and other dangerous lung infections.

Researchers from The Ottawa Hospital came up with the idea for the trial and worked with the Canadian Cancer Trials Group (CCTG) at Queen’s University to design and run it in centres across the country. Funding and in-kind support, valued at $2.8 million, is being provided by the Canadian Cancer Society, BioCanRx, the Ontario Institute for Cancer Research, The Ottawa Hospital Foundation, The Ottawa Hospital Academic Medical Organization, ATGen Canada/NKMax, and Immodulon Therapeutics, the manufacturer of IMM-101.

“An effective vaccine that provides specific protection against COVID-19 could take another year or more to develop, test, and implement,” says Dr. Rebecca Auer, study lead, surgical oncologist and Director of Cancer Research at The Ottawa Hospital and associate professor at the University of Ottawa. “In the meantime, there is an urgent need to protect people with cancer from severe COVID-19 infection, and we think this immune stimulator, IMM-101, may be able to do this.”

“This trial could support an important change to the standard of care for cancer patients by administration of IMM-101 prior to starting cancer treatment,” says Dr. John Bell, Senior Scientist at the Ottawa Hospital Research Institute, Scientific Director of BioCanRx and co-lead of OICR’s Immuno-oncology Translational Research Intitiative. “Accelerating to the clinic, biotherapeutics that can enhance the quality of life of those living with cancer.”

The trial, called CCTG IC.8, has been approved by Health Canada and is expected to open at cancer centres across Canada this summer. People who are interested in participating should speak with their cancer specialist.

“OICR is excited to be collaborating on such a landmark clinical trial supporting cancer patients in this unprecedented time,” says Dr. Laszlo Radvanyi, President and Scientific Director, OICR. “IMM-101 may be an effective approach to protect our vulnerable patients not only against COVID-19, but also to boost their immune system to fight cancer.”

Read the full release.

June 29, 2020

New radiotherapy method improves long-term survival

OICR Investigator-led phase II clinical trial shows long-term advantage of ablative therapy for patients with multiple tumours. Technology enters phase III clinical testing.

Varian TruBeam®
© 2010 Varian Medical Systems International AG, All Rights Reserved

For a long time, if a cancer had spread to another part of a patient’s body, it was thought to be incurable. Dr. David Palma and collaborators are challenging this notion.

In the phase II SABR-COMET clinical trial, Palma and colleagues evaluated the long-term effects of a modern type of radiotherapy, called stereotactic ablative radiotherapy (SABR), on individuals with cancers that have spread to a few organs. The results from the trial, which were recently published in the Journal of Clinical Oncology, show that SABR can extend the lives of these patients by a median of 22 months with an improvement in five-year survival of 25 per cent.

Continue reading – New radiotherapy method improves long-term survival

June 26, 2020

Opening the virtual floodgates for cancer research and discovery

OICR’s Genome Informatics team announces international release of the ICGC-ARGO Data Platform, the all-in-one data hub for the largest clinical-genomic data sharing initiative in the world

Dr. Christina Yung

We’re in the midst of an era of big data that is changing the way we understand the world – including how we study, diagnose and treat cancers. 

Improvements in sequencing technology and computational power have allowed us to collect massive amounts of information about cancer patients and their tumours. This information, however, is only powerful if it can be accessed by those who can transform big data into new discoveries. 

Over the last decade, OICR’s Genome Informatics has built a reputation for developing robust big data portals that provide cancer data access to thousands of researchers around the world. Now, the Genome Informatics team has set out to do it again – this time with bigger data. 

Continue reading – Opening the virtual floodgates for cancer research and discovery

June 25, 2020

CanPath Awarded $2.1 million CIHR Grant for SUPPORT-Canada COVID-19 Initiative

The SUPPORT-Canada initiative will capture data and biospecimens in order to identify factors contributing to COVID-19 susceptibility, severity and outcomes.

Dr. Philip Awadalla

CanPath (the Canadian Partnership for Tomorrow’s Health), co-led by OICR Investigator Dr. Philip Awadalla, has been awarded a $2.1 million grant from the Canadian Institutes of Health Research (CIHR) through their COVID-19 Rapid Research Funding competition. The initiative, titled SUrveying Prospective Population cOhorts for COVID-19 pRevalence and ouTcomes in Canada (SUPPORT-Canada),aims to capture data and biospecimens to enable population-level surveillance. SUPPORT-Canada will enable researchers and clinicians to find factors contributing to COVID-19 susceptibility, severity and outcomes, thus identifying factors predisposing individuals or communities across Canada to a high risk of infection.

“The integration of clinical programs with our broader existing population cohort infrastructure creates the opportunity to rapidly assess patterns across Canada, while discovering and tracking critical biological and environmental determinants of disease susceptibility and severity for COVID-19,” says Awadalla, who is the lead Principal Investigator for the SUPPORT-Canada Initiative and National Scientific Director of CanPath.

Continue reading – CanPath Awarded $2.1 million CIHR Grant for SUPPORT-Canada COVID-19 Initiative
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