May 6, 2021
Canadian Remote Access Framework for Clinical Trials brings new opportunities for cancer patients residing in rural and remote communities
The Canadian Cancer Clinical Trials Network (3CTN), has launched the proof-of-concept phase of the Canadian Remote Access Framework for Clinical Trials (CRAFT), which aims to broaden trial options for eligible cancer patients, regardless of where they live in Canada. Clinical trials are an important part of the cancer care system, particularly for those who have exhausted standard treatment options. Those who are far from a regional cancer centre where a trial may be available often face immense hurdles to participating, such as travel cost and time. CRAFT employs a hub and spoke, ‘trial cluster’ model, wherein the trial centre provides oversight for a patient’s community health centre to serve as a satellite site.
With funding support received from the Canadian Partnership Against Cancer, CRAFT was created by a collaborative group of patient partners, clinical researchers, trial sponsors, healthcare institutions, research ethicists and representatives from Health Canada who were united in a common vision to promote equity in the cancer system through improved opportunities for clinical trial participation for all eligible Canadian patients. When fully implemented, CRAFT aims to address many of the regulatory, ethical, legal and practical barriers that can impede the conduct of clinical trials in rural and remote communities.
Through CRAFT, centres interested in collaborating on a given trial can draw from resources created to support setup and oversight that assures patients receive the same level of quality and safety regardless of where they are seen. Funding provided by 3CTN will support proof-of-concept of CRAFT at three locations across Canada over the coming year:
Primary centre: Health Sciences Centre, Eastern Health: St. John’s, Newfoundland and Labrador
EXCITE Corporation/Central Newfoundland Regional Health Centre (Grand Falls – Windsor)
Western Memorial Regional Hospital (Corner Brook)
Leader: Dr. John Thoms
Primary centre: Health Sciences North: Sudbury, Ontario
Sault Area Hospital
Timmins District Hospital
Leader: Dr. Lacey Pitre
Primary centre: BC Cancer: Prince George, British Columbia
Mills Memorial Hospital (Terrace)
Kootenay Boundary Regional Hospital (Trail)
Leader: Dr. Robert Olson
“I am thrilled that through the CRAFT initiative we can start eliminating the barriers that exist for cancer patients in rural and remote communities in Canada,” says Dr. Janet Dancey, Scientific Director of 3CTN. “Thank you to all of our partners who came together to create a truly innovative solution that will move us closer to achieving equity in access to cancer clinical trials. We are confident that this proof-of-concept project will show that CRAFT is an effective approach and provide a springboard to expand the initiative.”
“As Newfoundlanders and Labradorians, we have all experienced challenges with regards to access to healthcare. Our beautiful province can act as a major barrier when considering accessibility to clinical trials for cancer patients living outside of the metro region. Everyone deserves access to the best possible level of care, despite geographic location,” says Stephanie Mayne of Newfoundland and Labrador, a patient partner and CRAFT working group contributor. “CRAFT provides us the opportunity to overcome these barriers and improve access to clinical trials. I am extremely proud to say that patients played a key role in shaping the framework and look forward to seeing its success.”
“We are excited to partner with local health authorities in B.C., including Northern Health and Interior Health, to facilitate clinical trial follow-up in patients’ home communities,” says Dr. Robert Olson, of BC Cancer in Prince George, B.C. “General practitioners in partner communities will undergo clinical trial training and help with patient follow-up, physical exams, and adverse event reporting, enabling patients from more remote communities, including First Nations, to commit to the multi-year follow-up programs needed for clinical trials.”
“Conducting clinical trials is a complex undertaking as there are many factors that must be considered such as regulations, trial requirements and the patient’s needs. CRAFT provides us with a comprehensive approach to conducting clinical trials in community hospitals by giving us the tools and resources we need to reach patients in remote communities,” says Christopher Lavoie, Clinical Research Supervisor at Health Sciences North in Sudbury, Ontario. “Our team is excited to be one of the first to implement CRAFT and we can’t wait to see the positive impact it has on patients in our communities and beyond.”
About the Canadian Cancer Clinical Trials Network
Established at the Ontario Institute for Cancer Research (OICR) in 2014, the Canadian Cancer Clinical Trials Network (3CTN) is a not-for-profit, pan-Canadian initiative aimed at supporting and improving the efficient delivery of academic cancer clinical trials through funding, resources and advocacy to improve the clinical trial environment and increase patient access to cancer clinical trials. Clinical trials are a vital component of Canada’s cancer care system and are essential to advancing cancer research to bring new solutions to patients. Funding for 3CTN operations is provided by OICR and the Canadian Partnership Against Cancer. Core funding for 3CTN member cancer centres is provided by provincial cancer agencies.
April 8, 2021
Genome Canada has announced the launch of a new, Canadian SARS-CoV-2 Data Portal that will manage and facilitate data sharing of viral genome sequences among Canadian public health labs, researchers and other groups interested in accessing the data for research purposes.
McGill University’s, Dr. Guillaume Bourque and his team will lead the project in collaboration with the Canadian COVID Genomics Network (CanCOGeN) and a number of world-leading genomics scientists specializing in data science, including Dr. Christina Yung, Director of Genome Informatics, OICR, and Dr. Lincoln Stein, Head, Adaptive Oncology, OICR.
The team will also collaborate with DNA Stack, a CanCOGeN industry partner led by OICR Associate Dr. Marc Fiume. The Data Portal will make use of DNA Stack’s COVID Cloud platform to develop and provide real-time analytical dashboards, data exploration and standards-compliant data interfaces.
March 24, 2021
OICR, Intensity Therapeutics and The Ottawa Hospital to conduct Window of Opportunity clinical trial in early-stage breast cancer
OICR, Intensity Therapeutics and The Ottawa Hospital have agreed to collaborate to conduct a Phase II randomized, window of opportunity (WOO) clinical trial evaluating an immunotherapy drug, called INT230-6 vs. the standard of care. Currently there is no treatment available to be given in the gap between the diagnosis of breast cancer and surgery, which is often four weeks long. It is believed the treatment will kill cancer cells and slow the spread of breast cancer prior to surgery.
“WOO trials form a key part of OICR’s new research strategy because they are essential in helping to identify new biomarkers and develop more precise diagnostics and treatments for patients,” said Dr. Christine Williams, Ph.D., Deputy Director, OICR. “This trial is the first in our newly-launched Window of Opportunity Network, and it shows the promise and enthusiasm for WOO trials across the research community. We are proud to be working with proven clinical and industry partners like The Ottawa Hospital and Intensity Therapeutics to determine the effectiveness of INT230-6 in helping early-stage breast cancer patients.”
OICR’s Diagnostic Development group, led by Dr. John Bartlett, will analyze subject immune responses and conduct biomarker analysis. The study’s Principal Investigator is Dr. Angel Arnaout, Professor of Surgery at the University of Ottawa and Scientist at The Ottawa Hospital.
Read the news release
March 9, 2021
OICR research team awarded $2.4 million to facilitate precision medicine for early-stage breast cancer
Partnership between Thermo-Fisher Scientific and OICR Diagnostic Development, led by Dr. John Bartlett, awarded support from Genome Canada’s Genomic Applications Partnership Program
The Honourable François-Philippe Champagne, Minister of Innovation, Science and Industry, has announced $8.6 million in federal support through Ontario Genomics via Genome Canada’s Genomic Applications Partnership Program (GAPP) to five applied genomics research projects that will improve the well-being of Canadians. As one of the five recipients, OICR’s Diagnostic Development program will receive $2.4 million to develop an epigenomic profiling tool to better understand the progression of breast cancer.
Working with Thermo Fisher Scientific, OICR’s Drs. John Bartlett, Jane Bayani, Melanie Spears and collaborators will investigate the effects of differences in ethnicity on breast cancer treatment and survivorship. Their ultimate goal is to make the delivery of targeted breast cancer treatment more equitable for Black and Asian women.
“Moving forward we want to understand how the complex relationship between biology and ethnicity can accelerate the delivery of the best treatments to patients, treating everyone as an individual based on the biology of their disease,” says Dr. John Bartlett, Director, Diagnostic Development, OICR.
Breast cancer, which was once considered a homogeneous disease, is now understood to be a variety of different types of cancer that require different types of treatment. Understanding the DNA changes that lead to breast cancer and the downstream effects of DNA changes on the cellular machinery – such as the epigenomics of the disease – helps us match the best treatment for each patient. Through this project, Bartlett, Bayani, Spears and collaborators will develop and validate new and improved tests to subtype and predict the severity of breast cancers. They will focus on comparing results between cancers in Black and Asian minority ethnic groups and other ethnic groups.
“We’re thrilled to continue working with Thermo Fisher to examine the role of ethnicity and develop new tools in the diagnosis of breast cancer,” says Dr. Melanie Spears, Principal Research Scientist, Diagnostic Development.
Genome Canada’s GAPP funds translational research and development projects that address real-world challenges and opportunities identified by industry, government, not-for-profits, and other receptors of genomics knowledge and technology. These targeted investments support outcome-oriented partnerships across sectors to generate Canadian-led solutions.
“This grant will give us the opportunity to bring additional precision medicine tests for breast cancer patients and examine the impact ethnicity has in the biology of these cancers,” says Bayani, co-lead investigator and Principal Research Scientist at OICR. “We’re excited to work with our industry partner and collaborators in moving personalize medicine forward,” says Dr. Jane Bayani, Principal Research Scientist, Diagnostic Development.
“Investing in genomics research with a line of sight to application is critical for the health and well-being of Canadians,” said Dr. Rob Annan, President and CEO of Genome Canada. “Genome Canada is proud to work with the Government of Canada to fuel demand-driven genomics research and innovation collaborations among academic, industry, health-care and other partners to shape a better, healthier future for Canadians.”
Learn more about this project: Development of an Epigenomic Profiling Tool to Facilitate Precision Medicine in Early Breast Cancer.
February 26, 2021
Text-based online support groups augmented with a new tool for detecting distress
Therapist-led online support groups can provide a safe space for people affected by cancer to discuss fear, normalize stress, build resilience and enhance coping. Cancer Chat Canada offers real time text-based support groups, but therapists who lead these groups often feel challenged to address the needs of each participant in the absence of visual cues. Recent Ontario-made advances in artificial intelligence (AI) may offer potential solutions.
In a paper recently published in JMIR Research Protocols, an Ontario-based research group outlines their new AI-enabled virtual therapy cofacilitator tool for online cancer support groups. The tool uses a machine learning algorithm based on interpreting patterns of speech and language to track support group participants’ progress in real-time, while providing feedback to the leading therapist.
The research initiative was supported by OICR through the OICR-Cancer Care Ontario (Ontario Health) Health Services Research Network, and led by Drs. Yvonne Leung and Mary Jane Esplen, experts in the psychological impact of cancer.
“Online support groups are accessible and effective at reducing cancer-related emotional distress, but it can be challenging to monitor individual participant distress and engagement while responding to multiple participants’ messages simultaneously,” says project lead Esplen, Professor and Vice-Chair, Equity and Mentorship in the Department of Psychiatry, University of Toronto and former Lead of the de Souza Institute. “With multiple participants typing at the same time, nuances of text messages and red flags for distress can sometimes be missed. Our tool serves as an AI-enabled cofacilitator that can enhance the therapist’s ability to address these concerns.”
With a tool that can detect and flag issues, therapists could prioritize concerns more effectively, provide more individualized support in real time, and direct treatment accordingly in a timely manner.
In 2020, the research group completed the first phase of their study, during which they developed the AI-enabled cofacilitator tool. Now, in the second phase, they are evaluating the tool’s effectiveness by scoring its ability to accurately output psychometric measures, such as fear, sadness and hopelessness.
“The goal is to visualize emotions and sentiments throughout therapy to make online group therapy more effective,” says first author Leung, who is an Assistant Professor at the University of Toronto. “We believe these tools and technologies can be used to strengthen person-centred care by attending to individual needs and expanding access to high-quality virtual health care. We’re delighted to be in the process of validating such a cutting-edge tool.”
Should effectiveness be demonstrated in their clinical studies, the group plans to integrate their AI-enabled cofacilitator into Cancer Chat Canada’s online psychosocial oncology services, and potentially adapt the cofacilitator algorithm for other cancer-related support services.
“We’re proud of the progress made so far,” says Esplen. “Our team was strategically built to incorporate different areas of expertise and different perspectives. We’ve tested each step along the way, and we look forward to building more tools to enhance patient therapy and care.”
February 17, 2021
The Journal of Clinical Oncology (JCO), one of the most prestigious journals in cancer research, recently added Dr. John Bartlett to its list of most-cited authors following an analysis by the analytics firm Clarivate. A clinical practice guideline update by Bartlett and his coauthors was the third most-cited article JCO published in 2018. The guideline, on HER2 testing in breast cancer, has been cited an outstanding 276 times. Bartlett is Director of OICR’s Diagnostic Development Program, which is working to develop new tools to guide precision medicine for cancer.
February 3, 2021
OICR Genomics believes high-quality cancer research starts with high-quality data. Since inception, their labs have been committed to quality, and now accreditation is within reach
Standards are all around us – making our lives safer and easier in many ways. In both research and medicine, laboratory standards help evaluate a lab’s quality, reliability and efficiency. Research lab standards help scientists generate reliable data leading to reproducible discoveries, but in medicine, lab standards help clinicians make more accurate diagnoses and treatment decisions. These different applications call for different standards and sometimes different schools of thought.
Since inception, OICR Genomics has been building a bridge between research and medicine, developing new standards for innovative genomics technologies while refining lab procedures so they can serve as the trusted genomics services provider for Ontario’s cancer community. Today, OICR Genomics is proud to provide high-quality services for cancer researchers, clinicians, and the patients they serve.
The journey to accreditation
Achieving and maintaining accreditation is an exceptionally rigorous process that requires steadfast diligence and meticulous lab management over a sustained period of time. Since 2018, OICR Genomics has been developing and improving processes and procedures to achieve accreditation by the Institute for Quality Management in Healthcare (IQMH) and the College of American Pathologists (CAP), two well-recognized leaders in lab accreditation.
There are three key elements that make accreditation possible:
Dedicated people. Every member of OICR Genomics is important to the accreditation process. Accreditation requirements include effective documentation and training protocols, a strong track record of good lab practices, continuous sharing and monitoring of technical results, appropriate validation and uncertainty correction methods, an extensive array of standard operating procedures, and more. Successful accreditation requires the collective effort of all lab staff – from students to senior researchers.
“I’m proud of our team’s commitment to the community,” says Dr. Carolyn Ptak, Program Manager and Quality Assurance Lead of OICR Genomics. “We have a great group that is flexible, innovative and committed to quality.
Balanced priorities. Given the complex and rapidly evolving field of cancer genomics, many laboratories face challenges associated with compliance. New tools and innovations call for new standards. OICR Genomics continuously strives to balance innovation, performance, efficiency and safety under the leadership of Dr. Trevor Pugh.
“As research continues to evolve, OICR Genomics will continue to as well,” says Dr. Trevor Pugh, Senior Investigator and Director of the Joint Genomics Program at OICR and the Princess Margaret Cancer Centre. “We’re excited by the current advancements in genomics and we look forward to continuous improvement in the years to come.”
Stable support. Over the last fifteen years, OICR has mobilized the community to transform cancer care through collaborative networks, transformative initiatives and more. Many collaborators have recognized the value of working with OICR Genomics and it is with their consistent support that the foundations leading to accreditation were laid.
“We are thankful for all the talented scientists who have worked with us throughout the years on innumerable genomic sequencing projects,” says Dr. Paul Krzyzanowski, Director of the Genome Research Platform, “Our newly accredited services will be available to clinical, academic, and industrial research clients and we’re excited to be able to support a whole new scale and scope of projects.
For the community
Genomics has become a central discipline of cancer research. It has unlocked new opportunities to predict cancer earlier and match patients with the most effective medicines for their disease. In parallel, advances in research methods and sequencing technologies have expanded the affordability and accessibility of genetic sequencing. Reading human DNA and RNA is no longer a multi-year, multi-million-dollar initiative, it can be done in hours or days at a fraction of that cost. These opportunities, however, can only be realized through the translation of research and innovation. For OICR Genomics, translation is at the centre of their mission – and rigorous lab standards help accelerate translation.
Within the cancer community, OICR Genomics’ lab standards can mean different things to different people:
- For the researcher, high lab standards and accredited lab services help you generate high-quality, reliable data in an efficient way. This means you can have more trust in your results and more reproducible discoveries.
- For the patient, high lab standards can help ensure that the community is effectively gaining knowledge from your donated biological samples. Accreditation of your local genomics research lab can also help your care teams apply the most recent discoveries to your treatment planning.
- For the province, these internationally recognized standards will help research teams use resources efficiently and effectively, maximizing the impact of finite resources, while attracting high-profile genomic studies to Ontario.
“Accreditation allows us to explore transformative new approaches to achieve health benefits,” says Dr. Laszlo Radvanyi, President and Scientific Director of OICR. “Ultimately, accredited lab protocols help our lab infrastructure serve as bridge between research and improved health.”
January 27, 2021
The high-impact, open-source journal Nature Communications has published an editor’s selection of interesting, recently published studies that “significantly move forward the rapid evolving field of cancer research”. OICR is prominently featured with eight of the 41 studies selected having an OICR senior researcher as an author. Many of the highlighted findings stem from the Pan-Cancer Analysis of Whole Genomes project, an unprecedented global collaboration led in part by OICR that generated the most comprehensive map of cancer genomes charted to date.
December 17, 2020
Dr. Jared Simpson and collaborators develop new nanopore-based methods to investigate two understudied aspects of disease biology
Studying DNA modifications may offer new insights into cancer – and the tools to read these changes are now in our hands.
In a recent publication in Nature Methods, OICR Investigator Dr. Jared Simpson and collaborators at Johns Hopkins University describe a new method to investigate two key aspects of disease biology, methylation and chromatin accessibility, simultaneously. These aspects can help describe how genes are organized and switched on and off in a cell, which may enable future progress in cancer research and discovery.
The group’s new method, coined nanoNOMe-seq, is built for nanopore sequencing – a fast, portable way to read long molecules of DNA. nanoNOMe serves as an additional tool that extends the utility of nanopore sequencing technologies.
“Our collaborators developed the lab protocols and we developed the analysis software to determine where DNA modifications occurred,” says Simpson. “Now, with this method, other researchers can investigate how DNA is modified within a cell to give an extra layer of information that the community can decode into new insights and discoveries.”
Dr. Michael Molnar, Scientific Associate in the Simpson Lab at OICR, led the development of the analysis software behind nanoNOMe.
“At times, it seemed like it might not be possible to develop a statistical model that could make sense of all the data,” says Molnar. “But we were able to persist and develop the nanoNOMe software, which showed a high degree of accuracy. We hope this method will enable others to discover long-range patterns and make new connections in sequencing data.”
nanoNOMe was first released as a preprint, which has already been cited in other scholarly articles including a tool for methylation pattern visualization, an analysis of human chromosome 8, and a published review on long-read sequencing among other publications. Simpson and Molnar’s collaborators plan to further investigate methylation and chromatin accessibility in human cancer cells with nanoNOMe.
“If you’re interested in understanding how methylation relates to open chromatin, then you can use this protocol,” says Simpson. “This is opening a new space for the community to explore interactions between chromatin and DNA methylation.”
December 2, 2020
Researchers at the University of Guelph and McMaster University create combination immunotherapy approach to treat breast tumours and other cancers
Over the last few decades, scientists have made significant progress in harnessing the immune system to treat cancers. Despite these advances, many types of cancer can still evade the immune system and current immunotherapies. Dr. Sam Workenhe is developing better treatment options for patients with these hard-to-treat diseases.
In his recent study, published in Nature Communications Biology, Workenhe and collaborators at the University of Guelph and McMaster University discovered a new combination immunotherapy approach for breast tumours and other cancers. Their approach leverages cancer-killing viruses, called oncolytic viruses, and chemotherapy to trigger tumour inflammation, stimulating the body’s immune system to control tumour growth. Their combination leveraged the oncolytic virus, oHSV-1, and the chemotherapy agent, Mitomycin-C.
The research team demonstrated the effectiveness of this treatment approach in mouse models of breast cancer. They found that that mice treated with this combination therapy lived approximately two months longer than untreated ones – a significant difference relative to the short lifespan of these mouse models.
“Simply put, we wake up the immune system,” says Workenhe, Assistant Professor at the University of Guelph’s Ontario Veterinary College and an OICR Joseph and Wolf Lebovic Fellowship Program awardee. “Our study proves that aggressive tumours without immune cells can be made to render an immune response. Understanding how to design treatments that can potentially activate the immune system against cancer can revolutionize the current standards of care.”
Additionally, the study delineated the anticancer mechanisms of their approach, detailing how each element kickstarts an immune response against the tumours. Workenhe, who is a trained veterinarian and a virologist, is now applying these findings to further study immune responses and inflammatory cell death in tumours.
“A lot of people are excited about engineering viruses to inflame the tumour and improve cancer treatment,” says Workenhe. “The implications of these findings for human cancer therapy may be huge.”
This post was adapted from a University of Guelph news story.
November 25, 2020
Despite disruptions, cancer researchers across Ontario are continuing to make scientific progress in labs and at home. Here, Vivian discusses her master’s project, discovering drug targets for future immunotherapies.
November 17, 2020
Dr. Brian Nieman takes a deep dive into the neurocognitive side effects of childhood leukemia treatment seeking new ways to improve the lives of survivors
Due to advances in the treatment of childhood acute lymphoblastic leukemia (ALL), more than 90 per cent of children diagnosed with the disease will live long and relatively healthy lives. However, there are still long-term neurocognitive side effects – or lasting effects – of treatment including attention, processing speed and motor coordination difficulties. Investigating these lasting effects at The Hospital for Sick Children (SickKids) is Dr. Brian Nieman, who is committed to further improving the lives of childhood leukemia survivors.
Recently published in Neuroimage: Clinical and Pediatric Research are two of Nieman’s latest studies on the neurocognitive impact of ALL treatment on growing children. In these studies, Nieman and collaborators discovered that many leukemia survivors have neurocognitive abilities that are comparable to other children but on average survivors are doing worse than their peers.
“We see that leukemia treatment has broad and lasting implications on the brain,” says Nieman, OICR Investigator and Senior Scientist at SickKids. “Determining when these key changes occur and which part of a child’s treatment is causative will be an important step in designing protective or rehabilitative strategies in the future.”
The study that was published in Neuroimage: Clinical was the first to investigate the impact of ALL treatment on the brains of survivors ages 8-18 using MRI. The study found extensive structural differences in the brain between survivors and their peers. The study published in Pediatric Research focused on quality of life measures, and identified the impact of leukemia treatment on IQ, behavioural measures, attention and cognitive abilities.
With this new knowledge and Nieman’s expertise in experimental mouse model imaging, he and collaborators are now investigating which chemotherapy drugs cause these lasting effects and when these developmental changes are occurring in a leukemia patient’s development. They strive to identify new strategies to protect and rehabilitate the developing child’s brain.
“Over the last few generations, we’ve seen childhood leukemia survival reach 90 per cent. Over the last few decades, we’ve seen a shift in practice that has allowed patients to experience fewer side effects. But these studies demonstrate that treatment isn’t ideal yet,” says Nieman. “The results that we’ve collected suggest that we could potentially help many leukemia patients and we’re committed to do so.”