May 17, 2019

What could we do if we had a clearer picture of prostate cancer?

OICR-supported trial finds new, more sensitive imaging technique can inform treatment decisions and benefit those with recurring prostate cancer

Prostate cancer is the most common type of cancer found in men, but managing the disease is difficult because not all prostate cancers are aggressive and overtreatment can lead to unnecessary side effects, such as hormone imbalances, bowel function issues and erectile dysfunction. After initial treatment, prostate cancer patients are often monitored with a prostate specific antigen (PSA) blood test, but this test provides no information about the location and the extent of the disease. Even with traditional bone scans and CT scans, remnant traces of the disease are difficult to find and often go undetected.

Dr. Glenn Bauman, Radiation Oncologist and Chief/Chair of the Department of Oncology at the London Health Sciences Centre and lead of the PICs study.

A few years ago, a new, more sensitive type of imaging technique had shown promise in early clinical studies abroad and Dr. Glenn Bauman, Radiation Oncologist at the London Health Sciences Centre, wanted to bring this technique into his practice. He recognized the potential benefits of this method, but didn’t realize how much it could impact the lives of his patients.

Bringing advances to local patients

The new technique, which was originally developed at the John Hopkins Hospital in Baltimore, consisted of a chemical probe, called [18-F]-DCFPyL, which would attach only to prostate cancer cells and light up in positron emission tomography (PET) scans. It can detect very small traces of a tumour that has returned after treatment or spread to a different part of the body.

Bauman teamed up with the co-inventor of [18-F]-DCFPyL, Dr. Martin Pomper, and the Centre for Probe Development and Commercialization (CPDC) to bring this probe to patients in Ontario. CPDC implemented the stringent manufacturing processes needed to create this probe and in March of 2016, Lawson’s researchers were the first to use this technique to scan a patient at St. Joseph’s Hospital in London.

A copy of the first [18-F]-DCFPyL PET/MRI (top) and PET/CT images (bottom) captured in Canada. (Photo: Lawson Health Research Institute)

“We teamed up with experts in [18-F]-DCFPyL from the U.S. and experts in prostate PET/CT from Australia to adopt this new technique, benchmark our methods and learn from their experience,” says Bauman. “It’s with collaborations like these that we can accelerate the implementation of new methods to help patients in Ontario.”

Evaluating the benefits for those with prostate cancer

Clinical studies are needed to evaluate the effectiveness new medical techniques in practice. For this technique, Bauman and collaborators needed to test whether it’s improved accuracy and sensitivity could help make better treatment decisions.

“Treatment plans for prostate cancer differ depending on the cancer’s size and location. Whether a cancer returns in the prostate, the pelvic area or elsewhere makes a big difference,” says Bauman. “We needed to test if more sensitive imaging techniques could help patients make better treatment decisions.”

Bauman led the design and development of the Advanced Prostate Imaging of Recurrent Cancer After Radiotherapy (PICs) study to evaluate [18-F]-DCFPyL PET/CT imaging. With OICR’s support over the following two years, PICs enrolled 80 men and scanned them with both traditional imaging methods and with [18-F]-DCFPyL PET/CT.

The study group found that not only can [18-F]-DCFPyL PET/CT detect smaller traces of the disease earlier when it is more manageable, this technique changed treatment recommendations for two in every five patients.

“With this technique, we were able to clarify and reclassify a lot of the traditional scans that were previously uncertain,” says Bauman. “This means that we were able to give prostate-directed treatment with confidence for patients whose cancers reemerged in their prostate and avoid the negative side effects of systemic hormone therapy for these patients.”

Bauman says that the technique also detected double the number of cancers outside of the prostate which were too small to be detected using traditional imaging alone.

Translating clinical findings into practice

Just three years after the first [18-F]-DCFPyL PET/CT scan was taken in Canada, Bauman has embarked on the next stage in translating these findings into routine practice. He and collaborators have teamed up with Cancer Care Ontario to provide access to the [18-F]-DCFPyL PET/CT technique in Toronto, London, Hamilton, Ottawa and Thunder Bay as part of a provincial registry program.

[18-F]-DCFPyL PET/CT can be applied to other challenges that patients and clinicans face with managing prostate cancer, including monitoring how patients respond to treatments. Notably, investigators in Hamilton are investigating how these scans can help predict a patient’s response to treatment in the OICR-supported MISTR trial.

“We have been sufficiently encouraged by our results from the PICs study, through which we have demonstrated the value of this intervention and how it can benefit men with prostate cancer,” says Bauman. “I’m proud to help bring better technologies to our patients in need and enable the adoption of these technologies throughout the province.”

Read more about our trials on OICR News.

October 16, 2018

Bringing cutting-edge imaging techniques to clinical trials

Dr. Catherine Coolens with new DCE-CT calibration device

OICR offers new CT calibration service as part of its Collaborative Research Resources portfolio

Using imaging devices to help make treatment decisions in the clinic requires rigorous testing, quality assurance and routine calibration of the imaging machinery. These standards are especially important when the imaging technology is novel or unique, such as in the case of perfusion imaging – a relatively new technique used to diagnose a cancer’s stage by showing how blood flows through the tumour.

Continue reading – Bringing cutting-edge imaging techniques to clinical trials

September 25, 2018

Breast cancer radiotherapy in a single visit provides more convenient option to patients, reduces burden of therapy

Seeds used in radiation therapy are shown, along with a penny to provide scale.

Cross-Canada research team moves image-guided ultrasound system into clinical development

Traditional breast cancer radiation treatment requires multiple hospital visits over a period of weeks or months, which may be onerous to patients who live far from hospitals or in remote communities. An alternative radiotherapy technique, Permanent Breast Seed Implantation (PBSI), requires only a single hospital visit, but it involves the implantation of multiple small radioactive metal pellets into the breast of the patient within millimetres of a target. The procedure to administer this treatment is difficult to plan and complex to execute – impeding the adoption of PBSI in the clinic.

Continue reading – Breast cancer radiotherapy in a single visit provides more convenient option to patients, reduces burden of therapy

September 13, 2018

Using imaging to better detect, characterize and monitor prostate cancers

Justin Lau

Sunnybrook researchers develop new magnetic resonance imaging methods to help differentiate between aggressive and non-aggressive prostate cancers

Current needle biopsy techniques have limited accuracy in detecting prostate cancer and determining the tumour’s aggressiveness. New methods are needed to better detect and characterize prostate cancer so that each patient can get the treatment that is most appropriate for them.

Continue reading – Using imaging to better detect, characterize and monitor prostate cancers

August 2, 2018

Ontario centre attracts national attention for probe research, development and commercialization

Centre for Probe Development and Commercialization

The Centre for Probe Development and Commercialization (CPDC) awarded $10.5 million to expand molecular imaging probe work in Ontario

Translating new scientific discoveries into products and moving those products to the market is a challenging process. This is especially the case for highly-regulated medical products such as radiopharmaceuticals – a special class of drugs that are used to accurately diagnose and treat diseases. Over the past decade, the CPDC in Hamilton has been bridging the gap between the innovation and commercialization of radiopharmaceuticals in Ontario and, in turn, reaping benefits for patients and the province’s economy.

Continue reading – Ontario centre attracts national attention for probe research, development and commercialization

August 9, 2017

CIMTEC appoints Justin Leushner as new CEO

The Centre for Imaging Technology Commercialization (CIMTEC) has appointed Mr. Justin Leushner as Chief Executive Officer. CIMTEC was established to accelerate the development of medical imaging technology and commercialize new technologies. Leushner brings extensive experience in both the private and public sectors. Most recently he was the Vice President at the TechAlliance of Southwestern Ontario, where he and his team worked with more that 300 companies in the region.

Continue reading – CIMTEC appoints Justin Leushner as new CEO

March 8, 2017

In London, OICR leaders discussed cancer research advancements being made in the city. How can OICR help further translate these breakthroughs to patients?

London, Ontario

Ontario’s wealth of cancer research expertise is not limited to one city or region. Innovations from researchers and clinician-scientists across the province are changing the approach to cancer worldwide. London is one of Ontario’s major cancer research nodes and boasts a particular strength in developing medical imaging technology. The city is home to the Lawson Health Research Institute, Robarts Research Institute and the Centre for Imaging Technology Commercialization. Life science and biotechnology research is the source of $1.5 billion in economic activity for the city annually.

Continue reading – In London, OICR leaders discussed cancer research advancements being made in the city. How can OICR help further translate these breakthroughs to patients?

September 16, 2016

“PEARLs” to improve photo-thermal cancer therapy

Dr. Gang Zheng

Photo-thermal therapy, a type of treatment that uses light and heat to destroy cancer cells, has shown great promise, but is still not widely used. A group in Toronto recently developed a technology that may go a long way in making the use of this type of therapy more effective and common.

Continue reading – “PEARLs” to improve photo-thermal cancer therapy

June 1, 2016

Making prostate cancer diagnosis more PRECISE

Dr. Laurence Klotz of the Sunnybrook Research Institute

Dr. Laurence Klotz of Sunnybrook Health Sciences Centre is a world leader in the field of prostate cancer research. He has been a champion of active surveillance (also known as watchful waiting) for over 20 years, an approach to prostate cancer treatment that has allowed thousands of men with low-risk prostate cancer to avoid or delay therapy by monitoring it closely instead of immediately treating it.

Now Klotz has launched a new clinical trial called PRECISE, funded with $3 million in support by the Movember Foundation, the Ontario Institute for Cancer Research and Prostate Cancer Canada, that will use MRI to help to better diagnose prostate cancer without invasive biopsy.

Continue reading – Making prostate cancer diagnosis more PRECISE