Dr. Gwyn Bebb wears three hats at the workplace: he is a medical oncologist at the Tom Baker Cancer Centre and is both a professor and researcher with the Cumming School of Medicine at the University of Calgary. His research focuses on identifying gene mutations that accelerate cancer growth and how to disable that growth using innovative therapies.
This was not always the plan. As a boy growing up in Bangor, Wales, Bebb envisioned a career in business. But after completing his bachelor’s degree in natural sciences at the University of Cambridge, he worked briefly at a pharmaceutical company. There, he met an inspiring oncologist and knew his fate was cast.
“That was the epiphany,” explains Bebb. “I applied to medical school and the rest is history.”
What followed was a bachelor’s degree in medicine from the University of Oxford, then fellowships and residencies at the University of British Columbia in Vancouver and the BC Cancer Agency. Vancouver is also where Bebb earned his PhD and nurtured his love of research, but he has practised in Calgary for the last 17 years.
During this time, he ran his own lab for 12 years (2005-2017) and directed the Clinical Trials Unit at the Tom Baker for eight years. And, since 2006, Bebb has led the Glans-Look Lung Cancer Research program, a unique platform that collects and analyzes medical information, outcomes data and lung cancer tissue from Alberta patients. These experiences provided the impetus for his latest research project: POET.
Established by Bebb in 2017, the Precision Oncology and Experimental Therapeutics (POET) program is based on a four key focus pillar structure: polyomic biomarker discovery, phase 1 precision oncology clinical trials, real-world evidence focused on precision oncology sub-populations and accessible polyomic profiling.
The precision oncology component is about researching how to treat cancer in a very “precise” way and involves assessing many biological aspects of each patient, such as targeting gene mutations in tumours. POET’s polyomic approach goes beyond that by using body materials, like blood and stool, to get more information on how cells affect cancer in the body. The result is “maximum impact and minimum toxicity,” Bebb says.
POET’s precision oncology component has become synonymous with identifying molecular anomalies in genes. In order to do that, the POET team — Bebb and 20 colleagues — has fostered a series of local and national collaborations to set up the Next Generation Sequencing (NGS) capability for solid tumours in Calgary. They have analyzed 160 tissue samples from Alberta patients living with a variety of cancers.
Using NGS and a slick machine called NovaSeq, the team “mashes up” each sample and extracts DNA and RNA. Up to 500 gene profiles per sample can be investigated at one time; mutations are identified within approximately 24 hours, and the team interprets and shares these findings with patients within four weeks. Reports then go to the patients’ oncologists.
But identifying gene mutations in tumours “is not meaningful unless you have the therapies that can exploit that,” explains Bebb. To that end, reports also include recommended prescriptions and/or existing clinical trials for patients and their health-care professionals to pursue.
Seamlessly merging the discovery of a mutation with the most effective treatment is not always easy. The ideal, or most precise, medication might still be in the research stage, or approved by the Food and Drug Administration in the U.S. but not yet by Health Canada. Or a compassionate request — permission to use a yet-to-be-approved medicine outside of a clinical trial — can be denied.
“This can be the most challenging part of all,” says Bebb, who lost a young lung cancer patient with a tumour gene mutation the evening before he was approved for a therapeutic. “It was an agonizing experience, a shattering disappointment.”
There have been some successes. New drugs are constantly being developed— Bayer, for example, has a new drug called larotrectinib that targets a mutation called NTRK, and a clinical trial for a breast cancer mutation started this summer — and pharma and biotech companies are using POET-based gene testing to identify patients for clinical trials.
However, there is more work to be done, says Bebb. “Since cancer evolves over time and cells change over time, we need to reassess the genomic landscape during the patient’s journey.” He is beginning to examine additional systems, such as the gut microbiome, where bacteria profiles are associated with poor or favourable cancer treatment outcomes. Thehope is to be able to influence the microbiome of individuals with cancer (using stool transplants or probiotic diets) to enhance the efficacy of cancer treatments.
Conducting this kind of evolutionary research takes a lot of money. NovaSeq was purchased in 2019 for $2.2 million. The Alberta Cancer Foundation contributed $530,000; the remaining cost was covered by the International Microbiome Centre at the U of C, which is sharing the equipment. The estate of the late Arnie Charbonneau, a well-regarded Calgary businessman and philanthropist, provided $4 million to support POET until 2026.
Bebb’s colleagues are impressed with his commitment to his patients.
“Dr. Bebb is one of the rare individuals who possesses the qualities of a consummate researcher, leader, educator, fundraiser, visionary, clinician and strong patient/family advocate,” says Dr. Don Morris, department head of oncology and facility medical director at the Tom Baker Cancer Centre. “We have been incredibly fortunate to have Gwyn’s leadership within our cancer research and clinical family.”
A dizzying workload like this is ripe for burnout, but Bebb knows how to decompress. He enjoys family time as well as socializing with friends, studying Welsh history, language and poetry, taking photographs and watching rugby. “And I like water – walking or cycling along the Bow River,” he says. “I find these activities a prime means of replenishing my soul.”
Since interviewing Dr. Bebb for this role, he has moved onto a new role outside of Alberta. We recognize all the rockstar work he was part of for Albertans facing cancer.
3 Questions with Dr. Gwyn Bebb
1. Describe what you do in 10 words or less.
Create an inclusive framework to advance precision oncology.
2. What is the biggest misperception about what you do?
That I only treat patients or that I only do research: I do both.
3. What motivates you?
A desire to help make all cancers curable.